Progressive Counting Certification Application

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Event(Required)

Name(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Highest Degree Earned(Required)

License Title(Required)

License Number(Required)

Documentation

Certificate of Completion of PC Training (from one of TICTI's qualified PC Training Programs)(Required)

Accepted file types: pdf, jpg, png, Max. file size: 16 MB.

Documentation of Completion of 15+ PC Group Consultation hours (provided by a TICTI-accredited PC Consultant) or Completion of TICTI's Certificate Program(Required)

Accepted file types: pdf, jpg, png, Max. file size: 16 MB.

Letter of Endorsement from a TICTI-accredited PC Consultant(Required)

Accepted file types: pdf, jpg, png, Max. file size: 16 MB.

Copy of your License, Registration or Certification for Independent Mental Health Practice(Required)

Accepted file types: pdf, jpg, png, Max. file size: 16 MB.

Agreements

Select Checkbox to Read and Agree to the Following Statement(Required)

I have completed at least 30 PC sessions with clients.

Select Checkbox to Read and Agree to the Following Statement(Required)

I have read and agree to adhere to my profession's Professional/Ethical Code of Conduct, as represented by the relevant professional association (APA, NASW, etc.), regardless of my membership status in that Association

Select Checkbox to Read and Agree to the Following Statement(Required)

I have reviewed and accept the complete TICTI Policies Statement at: www.ticti.org/policies

Select Checkbox to Read and Agree to the Following Statement(Required)

I agree to pay the full certification application fee of $250 promptly after the submission of this application form.

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About TICTI

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Distance Learning

Consultation

Certifications & Scholarships

Therapy

Special Programs

Books

Links

Articles

Treatment Approaches

Progressive Counting Certification Application

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Agreements

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