Okla. Admin. Code § 86:10-7-2

Current through Vol. 42, No. 8, January 2, 2025
Section 86:10-7-2 - Application materials and forms
(a) Each application shall include the following documents:
(1) Application form,
(2) Official transcript(s),
(3) Internship/Practicum Documentation Form,
(4) Completed criminal background check, and
(5) Fees.
(b) The Application Form requires the following:
(1) Identifying information;
(2) Possession of other credentials;
(3) Previous misconduct;
(4) Education; and
(5) Proposed professional practice.
(c) The Internship/Practicum Documentation form requires the following:
(1) Identifying information; and
(2) Time, place, location of practicum.
(d) The Supervision Agreement requires identifying information of supervisee and supervisor as follows:
(1) Name of candidate;
(2) Name of candidate's place of employment;
(3) Location supervised experience hours are being accrued;
(4) Candidate's contact information;
(5) Signature of Candidate;
(6) Name of Approved LPC Supervisor;
(7) Name of Approved LPC Supervisor's place of employment;
(8) LPC Approved Supervisor's contact information;
(9) Signature of LPC Approved Supervisor;
(10) Name of On-Site Supervisor;
(11) On-Site Supervisor's licensure information;
(12) Name of On-Site Supervisor's place of employment;
(13) On-Site Supervisor's contact information;
(14) Signature of On-Site Supervisor.
(e) The Verification of Academic Standing requires the following information:
(1) Name of applicant;
(2) Name of university;
(3) Name of graduate program;
(4) Name of degree;
(5) Total number of graduate coursework hours required to receive diploma;
(6) Date of graduation;
(7) Signature and signature date of applicant;
(8) Name of administrator and/or school official;
(9) Title/position of administrator and/or school official;
(10) Telephone number of administrator and/or school official;
(11) Email address of administrator and/or school official;
(12) Signature and signature date of administrator and/or school official.

Okla. Admin. Code § 86:10-7-2

Adopted by Oklahoma Register, Volume 32, Issue 24, September 1, 2015, eff. 9/11/2015
Amended by Oklahoma Register, Volume 36, Issue 21, July 15, 2019, eff. 7/25/2019
Amended by Oklahoma Register, Volume 40, Issue 22, August 1, 2023, eff. 8/11/2023
Amended by Oklahoma Register, Volume 41, Issue 21, July 15, 2024, eff. 7/25/2024