Child Life Practicum Application Packet Contact Information/Send To: Leah Yazmer, CCLS Child Life Practicum Coordinator Yale New Haven Children s Hospital Child Life Program SP 7-414 20 York Street New Haven, CT 06510 Phone: (203) 688-2336 (ext. 1) Email: Leah.Yazmer@ynhh.org Page 1
Child Life Practicum The Child Life Practicum Program is a 12-week, 140-hour placement, offered during the Fall and Spring semesters. The Child Life Practicum Program is designed as an introductory experience for individuals interested in pursuing a career in child life. Through experiential learning and observations of Certified Child Life Specialists, child life practicum students begin to increase their knowledge of basic child life skills related to play, developmental assessment, and integration of child life theory into interventions with children of all ages and their families. Through these experiences, child life practicum students will enhance their knowledge of the child life profession and investigate the process of applying child life and developmental theory into practice. At the completion of the practicum, the student will be eligible to apply for child life internships. Practicum Requirements 1. Successful completion of a minimum of 3 college-level courses within any combination of the following subject areas: Child Life, Child Development, Family Studies, Human Development, Psychology, Sociology, Counseling, Education, Expressive Therapies, or Therapeutic Recreation. 2. 50 volunteer/work hours completed in a pediatric hospital or other related areas (i.e. medical camp, rehabilitation center, hospice, educational setting for children with complex medical needs) 3. A minimum overall GPA of 3.0 Practicum Application Deadlines Interested Semester Application Acceptance Months of Placement Deadline Deadline Fall Semester April 1 st May 1 st September to December Spring Semester November 1 st December 1 st January to April ** Please note, students who complete a practicum at Yale New Haven Children s Hospital will be ineligible to apply for a child life internship at our facility ** Page 2
Child Life Practicum Application Checklist Completed Application Attached document addressing the four application questions (Must be typed) Letter of recommendation #1 (must be in a signed/sealed envelope) (someone who supervised and/or observed you interacting with children) Letter of recommendation #2 (must be in a signed/sealed envelope) Resume Verification of volunteer experience (minimum of 50 hours completed) Unofficial transcript (minimum 3.0 in major coursework) Signed application checklist By signing, I indicate that I have reviewed and met the application requirements. I am submitting all necessary documentation to be considered for a child life practicum experience at Yale New Haven Children s Hospital Signature: Date: PLEASE NOTE: **Submit all required documents in one envelope** **Envelope must be postmarked by the deadline date** Page 3
I. Demographic Information Name: Preferred Semester: Fall (Sept. Dec.) Spring (Jan. April) Present Address: How long will you be at this address? Primary phone: Email: Permanent address: (Leave blank if same as above) Emergency Contact Person: Contact phone: Relationship: Page 4
II. Academic Information Please list information for all colleges and universities attended University Name: Major: Minor: GPA (Cumulative): GPA (Major): Graduation Date: Degree: Bachelors Masters University Name: Major: Minor: GPA (Cumulative): GPA (Major): Graduation Date: Degree: Bachelors Masters University Name: Major: Minor: GPA (Cumulative): GPA (Major): Graduation Date: Degree: Bachelors Masters Page 5
III. Volunteer experience with children or families Institution Setting Population/Ages Responsibilities 1. Dates & Total Hours 2. 3. IV. Paid experience with children or families Institution Setting Population/Ages Responsibilities 1. Dates & Total Hours 2. 3. Page 6
V. Association of Child Life Professionals Relevant Coursework (All courses listed must be present on unofficial transcript) Course Number & Title Where Year Term Grade (i.e. Child Development) SCSU 2016 Spring A VI. 1. Two professional letters of recommendation: One letter of recommendation must speak to your skills and interactions with children and families. A second letter of recommendation should be from a professor, academic advisor, or manager. Please arrange for these letters to be sent with this application. Name Relationship Years of Affiliation 2. Page 7
VII. Please list any Certification(s): 1. 2. 3. 4. 5. VIII. Essay (Please type out answesr no longer than one page) 1. Describe an experience you had working with well-child(ren). 2. Describe an experience you had working with sick child(ren). 3. Explain what your expectations/goals are of a practicum in Child Life. What do you hope to learn and what aspects do you feel will be challenging for you? 4. Please explain your understanding of the role of Child Life. Do you plan to become a certified child life specialist? Why or why not? IX. Availability (Please list hours you are available for the interested semester) Monday Tuesday Wednesday Thursday Friday Saturday Sunday i.e. 8 to 3 not available 10 to 4:30 7:30 to 2 All day 12 to 8 10 to 6 (primary dates will be Monday through Friday) Page 8
Supervised Hours Working with Children Verification Form (Applicant: This form is to be completed by all places from which you are submitting hours.) I confirm that (applicant) has completed hours at (Institution) in (location) working with: (Type of experience check one) Working with children who are physically well Working with children in a healthcare or stress-related environment Working with children with special needs Working with typically developing children The applicants experience consisted of the following experiences: (list typical types of interactions with children): Signature/Credentials: Printed Name: Title: Date: Phone Number: Page 9