SUPERVISOR’S AGREMENTSupervisor Agreement • January 9th, 2021 • Nevada
Contract Type FiledJanuary 9th, 2021 JurisdictionCounselor Intern’s Name (Print or Type) Address Supervisor’s Name (Print or Type) Credential (CADC, LADC, LCADC) License # Co-Supervisor’s Name Credential (CADC, LADC, LCADC) License # Organization Phone AddressARTICLE I Parties City State Zip