Opioid Workforce Expansion Program Application Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Student ID*Email* PhonePlease list your practicum placement site.*Anticipated Graduation Date* Date Format: MM slash DD slash YYYY Degree Path*MSWMS – Counseling PsychologyPhD – Counseling PsychologyStatement of Interest in the OWEP, approximately 500 words, must include the following:*• interest in working with substance and opioid use disorders • career plan related to substance abuse prevention and/or intervention • what strengths the student possesses that will support the identified career plan? What personal or professional aspects might pose potential challenges? Accepted file types: doc, docx, pdf, txt.Consent* By submitting this application, if accepted, students commit to completing both the substance misuse and telehealth trainings that complement the practicum. Submission also indicates the student is in good standing with their program and the Graduate School.
