Expression of Interest: To Host Placement Students Expression of Interest: To Host Placement Students Thank you for taking the time to complete this form. Cairnmillar are seeking expressions of interest from organisations who may have opportunities to host placement students in 2024. Please complete the following form and we will be in contact with you to discuss your expression of interest. If you require further information, please contact our placement team by email placements@cairnmillar.org.au. Current Partnership Status: * We are currently hosting a Cairnmillar placement student We have hosted a Cairnmillar placement student in the past We have not hosted a placement student in the past but have been liaising with CMI staff Are you interested in hosting a placement student in 2024? * Yes No, but maybe following year No, please remove our details from your database Organisation Contact Details: Organisation Name: * Main Contact Person: * Role Title: * Main Contact Person’s Email: * Main Contact Person’s Number: * Suburb/s where placements may be available) * Website URL: * Street Address * Suburb * State * VICNSWWAQLDACTNTSATAS Postcode * Please indicate which placement students you are interested in hosting for 2024 (select all that apply): * Master of Professional Psychology Students (MPP; 5th year): 2-3 days/weeks for approximately 4 months. Master of Professional Psychology Practice (Interns; 6th year): 2-3 day/week s per week for approximately 12 months. Master of Clinical Psychology: 2 days/per week for between 4-5 months. Doctor of Clinical Psychology: 2 days/week for 4-5 months. Master of Clinical Psychology (Post-Registration): 2-3 days/per week for between 4-5 months. Graduate Diploma of Counselling: 1-2 days/ per week for between 4-5 months. Master of Counselling: 1-2 days/ per week for between 4-5 months. How many students can your organisation potentially host? * Who have you liaised with at the Cairnmillar Institute regarding student placements? * What client populations does the organisation predominantly provide services to? (check all that apply) * Children under 12 years old Children/adolescents aged 12-17 years old Adults aged 18 years and over Older Adults aged 55 years and older Couples Families OtherOther Please provide a brief description of the services provided by the organisation: * This will assist us to find students with interests that align with your organisation. Do you have any further information you wish to provide? * Are there opportunities for paid placements/internships with your organisation? If so can you please tell us a little more about these opportunities? Removal of organisation from Cairnmillar Institute Partnership Program Please fill in the below details. Agency / School Name: * Primary Contact Person: * Primary Contact Number: * Email Address: * Thank you for providing placement opportunities to our students over the years. We wish you well. Thank you for taking the time to complete this form. A Cairnmillar staff member will be in contact to discuss placement opportunities with you. The Cairnmillar Placement Team If you are human, leave this field blank. Submit Δ
