CBC Supervised Counseling Application

Name*

First Last

Email*

WHAT PROGRAM ARE YOU CURRENTLY IN?*

NUMBER OF COUNSELING COURSE HOURS YOU'VE COMPLETED*

ARE YOU A CURRENT MIDWESTERN SEMINARY OR SPURGEON COLLEGE STUDENT?*

AGE*

GENDER*

CHURCH NAME*

ARE YOU A MEMBER OF THE CHURCH YOU'RE ATTENDING?*

IN 250 WORDS OR LESS PLEASE GIVE YOUR TESTIMONY.*

IN 250 WORDS OR LESS, PLEASE GIVE YOUR COUNSELING PHILOSOPHY*

IN 250 WORDS OF LESS, PLEASE EXPLAIN WHY YOU WANT TO COUNSEL WITH THE CENTER FOR BIBLICAL COUNSELING?*