ERRORS GO HERE HP DateInternship Site Information UpdateSubmit this form to the Department of Counselor Education and your information will be updated.Site InformationSite NameWebsite URLStreet AddressCityState/ProvinceZIP/Postal CodePhone NumberSite Fax NumberAgency InformationAgency Contact NameAgency Contact’s License NumberAgency Contact TitleWhat Type of Taping is Allowed?VideoAudioBothNoneOne or Two Semester Commitment?One Semester RequiredTwo Semesters RequiredNo Semester RequirementsOtherAgency Contact's Phone NumberAgency Contact's Email AddressSite Hours of OperationSite Contact's ResumeSite Contact's LicenseDescription of Site and ClientsBy submitting this form you are agreeing that you have read, understand, and agree to uphold the policies outlined in the Site Contract. Submit