Northcentral University: The Marriage And Family Therapy Masters Program

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Northcentral University
The Marriage and Family Therapy Masters' Program
Student Acknowledgment Form
Student Name: Candace Williams
Northcentral University's Marriage & Family Therapy programs want to insure students are well informed about program requirements. All students are required to initial the following statements and sign the document at the bottom. Signatures must be either a certified/password protected digital signature or an original signature. You may not be typed in your signature. If you have any questions or concerns about these program requirements please contact the Chair of MFT Programs, Dr. Branden Henline at

Please place your initials after each section signifying that you have read and understand each responsibility: 1. I agree to abide by all University requirements as outlined in the current Northcentral University Catalog and cw as updated throughout my time at Northcentral.
2. I understand that I must take full responsibility for ensuring that my degree program at Northcentral meets the cw licensing requirements of my local state and/or country licensing board (where applicable).
3. I have read and understand the program policy statement that if I have been convicted of a felony prior to or subsequent to admission into the MFT program, I am required to immediately inform the Chair of the MFT cw Programs. I understand that such conviction may result in my dismissal from the program.
4. I understand that a minimum GPA of 3.0 must be maintained throughout the program and is required for graduation. I understand that I must earn a passing grade in not less than 66.6% of total credit hours cw attempted, and I must complete this program within 6 years.
5. I understand that I will be interviewed after I have successfully completed three courses (called the Initial
Review). As part of this process I understand I am expected to complete the Initial Review Questionnaire cw within the expected time limit.
6. I understand I will be evaluated to determine my clinical readiness to work with clients after I have successfully completed a minimum of the first six courses and before I can enroll in my first practicum cw course.
7. I understand that I may be placed on probation or other corrective actions by the University or administrative
MFT faculty for unsatisfactory academic progress or for unsatisfactory performance in other training domains, including, but not limited to, practicum placements, internship placements, professional or ethical violations or concerns. If I am placed on probation, I understand that a remediation plan will be developed cw which I am expected to follow; completing all required elements of the plan.
8. I understand that if I violate the University's student Code of Conduct and/or Academic Integrity policy I may be subject to immediate administrative dismissal, and would not qualify for readmission to Northcentral cw University.
9. I understand that as a student in this program and as a student therapist I am required to conduct myself in cw accordance with the most current edition of the AAMFT Code of Ethics.
10. I understand it is my responsibility to secure an appropriate practicum site and local supervisor as outlined in cw the Program Handbook.
© 2012 Northcentral University
10000 E. University Dr, Prescott Valley, AZ 86314 USA p: 928-541-7777 f: 928-541-7817

Northcentral University
The Marriage and Family Therapy Masters' Program
Student Acknowledgment Form
11. I understand I am responsible for keeping an accurate record of all of my client contact and supervision hours for review by my local supervisor(s), the NCU MFT faculty, and for the purpose of applying to state cw (or other) licensing boards.
12. I understand that in order to complete some of the course requirements, including the online supervision process used during the practicum courses, I will be required to participate in