Counseling Connections LPCA & LPC Application - Counseling Connections for Change, Inc

Name

First

Last

Email

Phone Number

I am a…?

How did you hear about Counseling Connections?

Do you know anyone that has been a client at Counseling Connections, or worked here before?

What specialty certifications and training have you had, if applicable? Otherwise, type N/A.

What are your professional goals and dreams?

Are you seeking a full-time or part-time clinical experience?

Do you require medical benefits? Otherwise, select N/A.

What days do you anticipate you would be able to work each week?

What types of clients do you feel most equipped or passionate about serving?

What languages do you speak?

or passionate before?

Do you have any questions or anything you would like to add?

Please Upload a Copy of Your Resume & Cover Letter Below

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

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