Application for FISD to provide practicum site - Diagnosticians
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Email *
Name *
Phone Number *
Email Address *
University Enrolled With *
How many hours are required for the practicum? *
Please describe any specific requirements for the hours or activities that need to be included in the practicum. *
Have you completed all coursework for test administration (cognitive and achievement) with a minimum grade point average of 3.0? *
Rate your comfort level with administering the WISC V independently. *
Needs significant support
Minimal support
Rate your comfort level with administering the WJ IV Cognitive independently. *
Needs significant support
Minimal support
Rate your comfort level with administering the KABC 2 independently. *
Needs significant support
Minimal support
Rate your comfort level with administering the WIAT IV independently. *
Needs significant support
Minimal support
Rate your comfort level with administering the WJ IV Achievement independently. *
Needs significant support
Minimal support
Rate your comfort level with administering the KTEA 3 independently. *
Needs significant support
Minimal support
Rate  your comfort level with writing a FIE report. *
Needs significant support
Minimal support
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