To be considered for one of our learning experiences, all requests for an internship, practicum, field placement, learning experience, observation or clinical rotation must be made to the agency’s recruitment specialist, Gwenea Jackson. In addition to the forms below, a letter of recommendation from the academic advisor, sponsoring agency, or VR counselor should accompany forms. The request should be received at least 60 days prior to the expected start date. Requests may be submitted to Gwenea Jackson, or P.O. Box 19888, Homewood, AL 35219-0888. She may also be reached at (205) 290-4515 or (800) 671-6837.

Required forms include:

• ADRS Learning Experience Policy Form
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• Either form should be signed by the student/consumer and academic advisor/sponsoring agency and submitted to the recruitment specialist.

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• ADRS Learning Experience Application
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• Completion of the application is required to be considered for a learning experience.

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• ADRS Learning Experience Confidentiality Form
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• Individuals requesting training must provide their signature in addition to the signature of a witness for either form.

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• ALEA Background Check Form
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• NO MONEY SHOULD BE SUBMITTED. ADRS WILL PAY TO PROCESS YOUR BACKGROUND CHECK. All information must be provided including notarization or information from two witnesses.

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• Insurance Liability Verification
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• Confirmation of coverage can be verified by submitting a certificate of insurance in lieu of this form.