Registration Request Form

MA Practicum Registration






If you are an MA student wishing to take additional practicum courses (ADST 5P21-26), please fill out this form to request registration approval. Without this form being completed you will not be able to register for any additional practicum courses. Please be sure to seek the approval from your Thesis Supervisor before filling out this form.

Please fill this form out a minimum of two weeks prior to web registration opening. Please consult the Important Dates link on the Faculty of Graduate Studies website to confirm web registration dates:

http://www.brocku.ca/graduate-studies/current-students

Registration Request Form

If Yes, Agency Name

If you have confirmed your placement site, please indicate the name of the Agency.

Location

Where is this agency located?

Please provide all contact information for the agency in which you plan to complete your practicum.

All students must complete 150 hours per practicum. Hours per week will be between 10 and 30. Please indicate the hours per week you estimate to be working.

Please provide the contact information for your Field Supervisor (include phone and email information)

Your BCBA Supervisor may be the same as your Field Supervisor.

Please provide the contact information for your BCBA Supervisor (include phone and email contact information)