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EPS 697 and CPP 697 Independent Studies Instructions & Form

“Incomplete” form

Graduation Application Information (Graduation Application section)

New EPS EdS and Masters graduate student orientation documentation

• • Professional Growth Plan (PGP) Form (PDF version)
  • Professional Growth Plan (PGP) Form (Word version)
• New EPS EdS and Masters Graduate Student Orientation Presentation
• EPS Program Agreement Contract
• EPS New Graduate Student Bookmark Document

Graduate assistantship

The Department of Educational Psychology graduate assistantship application due date is March 15, at 11:59 PM. ��Your application and��curriculum vita or resume must both be received by that date to be considered for a department graduate assistantship position for the next academic year. ��Please send your curriculum vita or resume to EPS@nau.edu.

• EPS Graduate Assistant Application (this link is now closed and will reopen in January 3, 2025)

Graduate scholarship (tuition waiver)

The Department of Educational Psychology graduate scholarship (tuition waiver) application due date is March 15, at 11:59 PM. ��Your application must be received by that date to be considered for a department graduate scholarship for any period within the next academic year.

• EPS Graduate Scholarship (Tuition Waiver) Application (this link is now closed and will reopen in January 3, 2025)

Student Professional Development Funding

EPS Student Professional Development Application
*Fall semester funding consideration, applications must be submitted by September 15
* Spring semester funding consideration, applications must be submitted by March 1
*��SPECIAL INSTRUCTIONS: Apply well in advance of your planned event registration or travel date, and ensure your letter/email of support is submitted quickly.�� Your application will not be reviewed until a letter/email of support is received

Graduate Student Organization (GSO)

COE Dean’s Graduate Research/Travel Grant Program Application

Travel Related Information:

NOTE: As of July 1, 2023 Personal Funds cannot be used for Conference Registration, Airfare or Lodging.�� Please review the EPS Department Travel Workbook for travel restrictions and instructions

• EPS Department Travel Workbook
• COE Travel Request Form��
• – Certification valid for three-years
• – Required once per fiscal year
• Multiple Occupancy Form Instructions
  • Multiple Occupancy Form
• Post-Travel Itinerary
  • Sample EPS Travel Itinerary
• Post-Travel Mileage Log
• NAU Travel: Cost Comparisons Instructions
• Travel Policy
• – Required once per fiscal year
• Policy Compliance Review Instructions

Purchase or Reimbursement Related Information (non-travel related):

• EPS Department Non-Travel Purchase Instructions

Records Retention Schedule

• Records Management at NAU

EPS Practicum Clinic Manual (current)
Practicum Master Syllabus (rev. 2020)

Client file documents (for Clinic)

• All client file documents for the Clinic are available through our electronic health records (TherapyNotes)

As-Needed clinic documents

• Client Safety Plan
• No-Suicide Contract

Documents for practicum students’ notebooks

• Confirmation of Group Supervision Form
• Counseling Supervision Log
• Documentation of Observation Form
• Practicum Clinic Confidentiality Statement
• Hourly Log for CMHC Counselors-in-Training
• Hourly Log for School Counseling Counselors-in-Training

Evaluation documents (completed by NAU Practicum Clinic Faculty)

• (�󾱱����-���������)��

Evaluation documents (completed by Field Supervisor)��

• (End of Practicum only, 2019 – on)

Evaluation documents (completed by Practicum Clinic Students)

• (Field-Based)��
• (Field-Based)��

Recruiting clients

• Class Credit Form
• Free Counseling Form

Before Internship Begins:

1. Before an internship can begin, there must be an NAU Affiliation Agreement in place. This is required per NAU Policy on Affiliation Agreements. Please review this document��for further information regarding Affiliation Agreements and instructions for how to set-up an Affiliation Agreement with your desired Internship site.
2. CMHC Internship Manual & Syllabus
3. Sample of a Completed CMHC internship Contract
4. Step 1, Rough Draft of CMHC Internship Contract��
6. (in addition to the required individual liability all Practicum and internship students must carry)

Before Internship Begins – Supervisor Orientation, Consultation & Professional Development

2. Site Supervisor Orientation Video #1 Handout��
5. One Free Continuing Education Unit (CEU) for Site Supervisors: Case Conceptualization Via Integral Theory

Throughout internship:

1. M.A. CMHC Internship Hourly Log

Mid-Point (before reaching 300 total hours):

2. (mid-pt)
3. ��(mid-pt)
4. (mid-pt)
5. (mid-pt)
9. (for interns)

Final (Near the end of internship – just before reaching 600 total hours):

2. (final)
3. ��(final)
4. (final)
5. (final)
6. (final)
10. (for interns)

Additional Intern forms:

1. Multicultural and Social Justice Competencies

Before Internship Begins:

1. Before an internship can begin, there must be an NAU Affiliation Agreement in place. This is required per NAU Policy on Affiliation Agreements. Please review this document��for further information regarding Affiliation Agreements and instructions for how to set-up an Affiliation Agreement with your desired Internship site.
2. School Counseling Internship Manual (March 2022)
3. Internship timeline & checklist
5. Sample of Completed School Counseling Internship Contract

Supervisor Orientation, Consultation & Professional Development

Throughout Internship:

1. M.Ed. School Counseling Internship Hourly Log

Mid-Point Evaluations (before reaching 300 total hours):

5. c

Final Evaluations (Near the end of internship – just before reaching 600 total hours):

Additional Intern Resources:

3. Multicultural and Social Justice Competencies

NAU Faculty Forms:

EPS Practicum Clinic Manual (Spring 2017)

• Authorization for Release of Information Form
• Case Review for Quality Assurance Checklist
• Class Credit Form
• Confirmation of Group Supervision Form
• Counseling Supervision Log
• Documentation of Observation Form
• EPS Counseling Psychology Doctoral Practicum Evaluation Form
• Free Counseling Form
• Intake Interview Report Form
• List of Clients Log
• Mental Status Behavioral Checklist
• No-Suicide Contract
• Progress Notes Form
• Request for (Families – Couples) Services Form
• Request for (Individuals) Services Form
• Session Rating Form
• Termination Summary Form
• Treatment Planning Form
• Practicum Clinic Confidentiality Statement

EPS 608 Student Affairs Fieldwork Handbook (11-20-19)

• Student Affairs Fieldwork Contract
• Student Affairs Fieldwork Faculty Supervisor Contact Form
• Student Affairs Fieldwork Student Evaluation Form
• Student Affairs Fieldwork Student Evaluation of Faculty Supervisor Form
• Student Affairs Fieldwork Student Evaluation of On-Site Supervisor Form
• Student Affairs Fieldwork Student Evaluation of Site Form
• Student Affairs Fieldwork Weekly Narrative Reflection Form

EPS 682 Student Affairs Practicum (Internship) Handbook

• M.Ed. Student Affairs Internship Contract
• Evaluation of Student’s Internship Experiences
• Faculty Supervisor Contact Form
• Intern Evaluation of NAU Faculty
• Intern Evaluation of On-Site Supervisor
• Intern Evaluation of Site

• Ed.S. School Psychology Handbook (Fall 2016)
• Ed.S. School Psychology Handbook (April 2016)
• Ed.S. School Psychology Handbook (Summer 2020)
• Ed.S. School Psychology Handbook (Spring 2021)
• Ed.S. School Psychology Handbook (Spring 2022)

• Combined Counseling/School Psychology Doctoral Student Handbook
• Combined Counseling/School Psychology Doctoral Practicum Handbook��
• Combined Counseling/School Psychology Doctoral Student Checklist
• Intent to take Discipline Specific Knowledge (DSK) / Doctoral Comprehensive Examinations form
• Dissertation Funding Support Application