ࡱ> -/,a bjbj 8M\M\j8Pdxxxxx}$"xx?Fxx}}x0m&*ji0xXxxtx> : CENTRAL CONNECTICUT STATE UNIVERSITY Department of Counselor Education and Family Therapy SCHOOL COUNSELING - PARENTAL RELEASE FORM Parent Name:_________________________________________________________________ Address:____________________________________________________________________ Phone:___________________________(Home)___________________________(Work) The Graduate Department of Counselor Education and Family Therapy at 91Ʒ Connecticut State University conducts a Counseling Practicum/Internship Course each semester at the University. The Counseling Practicum/Internship Course is an advanced course in counseling required of all Degree Candidates in the Counseling Program. Students Name: would like to work with your son/daughter, __________________________________________________, a student at _______________________________________________________________ School. The counseling sessions conducted with your child will be audio taped and will only be reviewed for educational purposes. All information will remain confidential. All audio tapes made will be erased at the completion of your childs involvement in the program. We hope that you will take the opportunity to have your child become involved in the Counseling Program. If you are willing to have your child participate, please sign the form where indicated. Thank you for your cooperation. Parents Signature _______________________________________________________ Date: _______________________________     SC-10 :HZ\p  < = ~   < P j   ijkmnpqstvwxÿhlhh 0jh 0Uh;nhU^dhO h(hOEjhJRCJUmHnHuhhj)hJR hJR5\h;rhJR5>*\h;r5>*OJQJ\^Jh;r5CJ OJQJ\^J h5\ h;r5\2%&[\$ % n o p    Dgd;ndgdj)dh`$a$$a$gd;rDjlmoprsuvwx~dgdj)hJRh 0h(hh(CJaJhlh 6&P1h:p9^/ =!"#$ % s666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontViV 0 Table Normal :V 44 la (k ( 0No List 4@4 Header  !4 @4 Footer  !PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]    D 8@(  \B  S D1"?B S  ?Ttjlmoprsuv%+jlmoprsuv333ijlmoprsuv}*t(O JR#5 / 0OEgkFCK