Supervisee Registration Supervisee Registration Please Enter Your Full Name Please Enter Your Email (This will not be publicaly displayed) Please Enter Your Phone Number (This will not be publicaly displayed) Please enter your City/County and State Student or Certified Professional looking for more experience? Student Certified Professional Year coursework began? School(s) you've attended? Who is your current supervisor? How are you tracking hours? BACB Tracker Self-tracking Are you looking for individual, group, or both? Individual Group Both Expected test date or date of certification? Hours Needed? Restricted vs Unrestricted Restricted Unrestricted Both Maxiumum Hours? Setting In-Home Private School Public School Clinic Community Hospital Residential Day Support Other Institution Other Setting Requested Age range Requested Population ID DD Autism ED General Other Population What is your other population? What you are doing now Availability Past degrees and institutions Narrative for what you are looking for in a supervisor and/or experience Volunteer or paid or either? Volunteer Paid Either Remote, onsite, or either? Remote Onsite Either
