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You may be contacted by a representative of the Sage Colleges to verify student participation or other details.
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You may be contacted by a representative of the Sage Colleges to verify student participation or other details.
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The candidate will be working at our agency as: *
Check all that apply.
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The candidate will not be allowed to work with any client with whom they are related: *
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Does this agency serve clients diagnosed along the Autism Spectrum Disorder or with other severe disabilities? *
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Will the candidate have the opportunity to work with at least five (5) different clients over the course of the practicum experience? *
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Students are expected to complete 17-20 practicum hours each week for a total of 250 hours by the end of the semester. Students with more than one hosting agency may work fewer than 17-20 hours week at a given agency.
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Does the agency employ a BCBA who is able to provide supervision, or will the agency allow for the candidate to participate in compliance with the BACB’s practicum regulations by consenting to the presence of a Sage appointed BCBA supervisor? *
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Will the agency allow one or more of these forms of supervision by their own BCBA employee or by a Sage appointed BCBA supervisor? (Face-to-Face is the preferred method of supervision.): *
Check all that apply.
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Will the agency allow the student to participate in these types of activities? *
Check all that apply.
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From http://www.bacb.com/index.php?page=69
Examples of activities that will not count as experience include: attending meetings with little or no behavior-analytic content; providing interventions that are not based in behavior analysis; performing nonbehavioral administrative activities; and completing nonbehavioral assessments (e.g., diagnostic assessments, intellectual assessments), paperwork, documentation, billing, or any other activities that are not directly related to behavioral analysis.
Does the agency understand that these activities are not appropriate for practicum experience? *
Attending meetings with little or no behavior analytic content; Providing interventions that are not based in behavior analysis; Doing non-behavior analytic administrative activities or any other activities that are not directly related to behavior analysis (www.bacb.com)
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Will a qualified member of this agency verify the student’s practicum hours at https://www.sage.edu/academics/esteves-school-of-education/applied-behavior-analysis-programs/applied-behavior-analysis-practicum-agency-forms/ at the end of the practicum? *
The student will alert the agency representative when this date is approaching. Students will be unable to receive a grade in practicum until the agency verifies that at least 250 practicum hours have been completed.
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The agency understands that they have the right to terminate the student’s practicum arrangement at any time. *
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Let us state once again how pleased we are that you have opened your agency to a Sage student to allow them to experience a very valuable form of education. This hands-on experience will assist them in their professional and personal growth in ways that only practical experience can. By signing this document, you attest to the validity and truthfulness of the information supplied in this contract and that the relationships between the hosting agency, the student and the BCBA Supervisor may proceed in compliance with BACB regulations and the program rules set by The Sage Colleges.
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I understand this is a legal representation of my signature.
Clear
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