Foundation
for Human Enrichment
doc.
date 2.24.06
Assistants
Application Check List
*Please
note: incomplete applications will not be accepted.
Please submit all documents when you submit your application or it will
be returned to you. For letters of reference, please have
faculty member send the letter directly to you, not the FHE office.
I am
submitting my application and requested information to be considered as one of
the following:
_____
General Assistant
_____Primary Assistant
_____ Senior Assistant
Personal
Session Provider:
_____ Beginning _____ Intermediate _____ Advanced
Individual
Case Consult Provider:
_____ Beginning _____ Intermediate _____ Advanced
Group Case
Consult Provider:
_____ Beginning _____ Intermediate _____ Advanced
Please
fill out the relevant section below, and submit the required documentation along
with the completed checklist.
ASSISTING
- General
All
levels
_____
Letter of recommendation from faculty attached
_____
Current CV attached
_____
I belong to a professional association with its own Code of Ethics
My membership expires _____
______ I
carry professional liability insurance
My policy expires _____
Beginning
_____ I
have completed the Intermediate year of training
Intermediate
_____ I
have completed the Advanced year of training
_____ I
have assisted at all modules of the Beginning year (assistant’s log attached)
Advanced
_____ I am
an SEP
_____ I
have assisted at all modules of the Intermediate year (assistant’s log
attached)
ASSISTING
– Primary
All
levels
_____
Letter of recommendation from faculty attached
_____
Current CV attached if copy on file with FHE is more than 3 years old
_____ I
belong to a professional association with its own Code of Ethics
My membership expires _____
_____ I
carry professional liability insurance
My policy expires _____
_____ I am
an approved session provider for the year for which I am applying to assist
Intermediate
____ I
have provided sessions for credit for Beginning year students
Advanced
____
I have provided sessions for credit for Intermediate year students
ASSISTING
– Senior
_____
Letter of recommendation from faculty attached
_____
Current CV attached if copy on file with FHE is more than 3 years old
_____ I
belong to a professional association with its own Code of Ethics
My membership expires _____
_____ I
carry professional liability insurance
My policy expires _____
_____ I am
an approved session provider for the Advanced year
_____ I am
an approved provider of individual case consultations for the Advanced year
_____ I am
an approved provider of group case consultations for the Advanced year
_____ I
have been providing group case consultations for at least one year, or have
given a minimum of 5 group case consultations
_____ I
have assisted at 2 full cycles of all levels of training
SESSION
PROVIDER
All
levels
_____ I
am an SEP
_____
I have assisted at all modules of the year for which I am applying for
provider status
_____ I
have an active SE practice and have provided at least 150 SE sessions to clients
to date
_____ I
belong to a professional association with its own Code of Ethics
My membership expires _____
_____ I
carry professional liability insurance
My policy expires _____
Intermediate
_____I am
an approved session provider for the Beginning year
_____ I
have provided sessions for credit for Beginning students
Advanced
_____ I am
an approved session provider for the Intermediate year
_____ I
have provided sessions for credit for Intermediate students
INDIVIDUAL
CASE CONSULTANTS
All
levels
_____ I
have had a professional practice in a related field for at least 5 years
_____ I
have assisted at least 2 full cycles of the year for which I am applying for
provider status
_____ I
have assisted at least once for a full cycle of an Intermediate and an Advanced
training
_____ I
have given at least 300 SE oriented sessions to date
_____ I
currently have an active SE practice
_____Recommendation
letters from 2 faculty members attached
Intermediate
_____ I
have given a minimum of 20 individual case consultations for Beginning students
_____ I
have assisted at least 2 full cycles of the Intermediate year
_____
Recommendation letters from 2 faculty members attached
Advanced
_____ I
have given a minimum of 20 individual case consultations for Intermediate
students
_____ I
have assisted at 2 full cycles of the Advanced year
_____
Recommendation letters from 2 faculty members attached
GROUP
CASE CONSULTATION
_____ I am
a Senior Assistant or have been accepted to the faculty track
_____ I
have given a minimum of 20 individual case consultations for Advanced students
_____ I
agree to have a maximum of 10 participants in group case consultations
_____I
agree to receive consultation from a faculty member
By
submitting this application, I am certifying that I have read the Assistants,
Approved Provider and Case Consultation Guidelines, document date 02.24.06.
I further certify that I meet the requirements stated in these guidelines
for the level of assisting or providing requested in this application.
I agree to represent the Foundation for Human Enrichment in a
professional manner at all times when assisting and working with clients.
I understand the fee structure stipulated in the agreement and agree to
adhere to these guidelines when working with participants in the SE training
program.
______________________________
Signature