Application for Supervisor Reimbursement

Students paying “out of pocket” for BCBA supervision, please complete the Application for Supervisor Reimbursement Form pre-placement.

Important Notes:
CLOSING DATE – D10 > September 11
CLOSING DATE – D11 > January 15

Application forms are to be submitted by these dates. Applications submitted after these dates will not be reviewed and supervisor reimbursement will not be available.

Maximum payment per term is $500. This amount is not guaranteed.
The amount payable is dependent on the number of requests received each term.

Payments will be made directly to the placement supervisor or the Agency.
SIN will be required to finalize payments and T4 slips will be issued.

1 Student Information
2 Supervisor Information
3 Practicum Information
  • Student Name * Required
  • Program * Required
  • Student's Employment Status * Required
  • Grant Assistance Program? * Required
    Is your tuition, fully and/or partially, reimbursed by your employer or the grant assistance program for Autism professionals?
  • Financial Assistance? * Required
    Do you require financial assistance to pay for BCBA supervision?
  • Course * Required