Clinical Mental Health Application
Please read through all questions below first before beginning the application process. Note that you will be sending a request to 3 professional recommendations for yourself, as well as uploading an essay written in APA 7th edition format. You must also sign at the bottom of this page to ensure submission of your completed application. In order for your application to be processed, you must submit a $50 application fee linked at the end of the application. Please email our Graduate Admissions staff with questions: Kate Belt, belt.k@wvwc.edu
Name
*
First Name
Last Name
Preferred First Name
Pronouns
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Social Security Number
*
Date of Birth
*
-
Month
-
Day
Year
Date
Home Phone Number
*
Please enter a valid phone number.
Cell Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Start Term
*
Please Select
Fall 2025
Are you enrolled in another graduate program?
Yes
No
List other graduate program enrolled
*
Have you ever been: Convicted of or plead to a misdemeanor and/or felony, suspended or expelled by a prior institution, or been disciplined through or named a respondent in a Title IX or sexual misconduct process?
*
Yes
No
Legal sex
*
Please Select
Male
Female
If you would like the opportunity, we invite you to share more about your gender identity below
Pronouns
Essay
Please submit an essay written in APA 7th edition that addresses the following prompt: Describe your current interest and understanding of counseling as a field.
*
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References
3 professional references are required to complete your application. Please send this link to your references: https://form.jotform.com/232065995368166
Transcripts
Official college transcripts are required to complete your application. Please upload all completed collegiate coursework for consideration into the Clinical Mental Health program.
*
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Application Fee
A $50 application fee is required for your application to be reviewed and processed. You'll be redirected to the payment page upon submission of the application
Signature
*
Submit and Pay Fee
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