Intern with Titus!

Fill out the inquiry form if you are interested in an internship with Titus Counseling Associates! We provide all counseling interns with weekly 1:1 licensure supervision and 2x monthly licensure group supervision. Our group strives to provide excellent on-the-job training and a diverse experience while still maintaining and enjoying the subtlety and charm of a smaller practice setting.

rtitus@tituscounselingassociates.com
(508) 863-4412

500 East Washington St., North Attleboro MA 02760

Titus Counseling Internship Application Form

Personal Information:

Name

First Name

Last Name

Date of Birth

YYYY

Gender

Male

Female

Prefer not to say

Other:

Phone Number

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Information

First Name

Last Name

Phone Number

Relationship

Parent, spouse, partner, friend etc.

Educational Background:

Internship Details:

Name of Current Academic Institution

Address of Current Academic Institution

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Degree Program

Master's

Doctorate

Other Degree:

Major/Field of Study

Expected Graduation Date

YYYY

Preferred Internship Start Date

YYYY

Preferred Internship End Date

YYYY

Available Hours per Week

This can be a rough estimate

Are you seeking to complete this internship for academic credit?

Yes

Experience and Skills:

Previous Counseling Experience

A brief description of positions held, organizations worked for, duration of time at positions, and duties performed in mental health

Relevant skills:

Personal Information:

Why are you interested in this internship?

(200 words max)

What are your career goals in the field of counseling?

(200 words max)

Do you have any specific areas of interest within counseling?

(200 words max)

Please provide any additional information you feel is relevant to your application

(optional)

Please add information for any references or points of contact you think we should have

I.e. Full Name/title, Relationship, Phone and/or email contact info.

By submitting this application, I certify that the information provided is true and accurate to the best of my knowledge.