Apply for the Foundations of Clinical Supervision Certificate

Application Deadlines:

Spring Foundations in Clinical Supervision Certificate: February 1 
Fall Foundations in Clinical Supervision Certificate: September 1

Submitting Additional Materials

All materials may be submitted using the application form below. If you need to submit any materials after you have submitted your application, please email them to the Office of Professional Education.

Required Application Materials

Your application packet must include the following:

  • Application form (available online only)
  • $40 nonrefundable application fee
  • Current résumé
  • Personal statement (two to three pages) responding to the following:
  • Describe any previous or current experience you have in providing supervision as a supervisor (i.e. where did you supervise, the context, who did you supervise, for how long, etc.).
  • Describe any plans you have to take on supervisory responsibility in the next two years? If so, do you anticipate supervising staff or interns?
  • What are your professional and personal reasons for choosing to be a clinical supervisor?

Online applications MUST be paid by credit card (MasterCard or Visa only). All online applications will receive confirmation of receipt by email; if you do not receive confirmation that your application was received (within 48 hours), please contact us.

  • Current Basic Information
  • Personal Information
  • Employment Information
  • Optional Information
  • Required Supporting Documents
  • Submit Your Application
  • Complete

Accessibilty

If you are unable to use this form, email us or call us at (413) 585-7970.


Basic Information

Full Name
Title

License Information


Supervisory Experience

Are you a currently an active SSW clinical supervisor (supervising Smith MSW student(s) this current year with plan to continue next year)?