Supervisor Registration Supervisor Registration Please Enter Your Full Name and Title Please Enter Your Email Would you like your email to be public? Please Enter Your Phone Number (This will not be publicaly displayed) Practicum vs. Fieldwork Practicum Fieldwork Both Neither List the universities you are associated with separated by commas. Group vs. Individual Group Individual A mix of the two Volunteer vs. Paid Volunteer Paid Cost Of Supervision? Setting In-Home Private School Public School Clinic Community Hospital Residential Day Support Other Institution Other Setting Please Specify Other Setting Please Specify Other Institution Population ID DD Autism ED General Other Population Please Specify Other Population Age Range Travel? Remote Onsite Both Your City/County and State? Type of hours offered? Restricted Unrestricted Mix of both What is the maximum number of hours offered? Providing supervision since? Short Description of Opportunity (limit 150 words) Supervisor Bio (giving some information about the supervisor including background and education relating to the oopportunity)
