Clinical Mental Health Application

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 NameLast Name
Preferred First Name
Pronouns
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number*
Date of Birth*

MonthDayYear
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*

Spring 2024Fall 2024
Have you ever been convicted of a misdemeanor and/or felony?*

YesNo
Gender*
If you would like the opportunity, we invite you to share more about your gender identity below
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.
*

Cancelof
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.*

Cancelof
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*

Clear
Should be Empty:

Clinical Mental Health Application

Essay

References

Transcripts

Application Fee