Pastoral Counseling Center
Online Christian Counseling Degrees
"You shall know the truth and the truth shall set you free" John 8:32
Christian Counseling Education Christian Counseling Training Education & Training For Christian Counseling
BA MA PhD Christian Counseling Degrees
Become An NCCA Certified Christian Counselor
Call Toll Free (877) 258-1047  Or Call (941) 756-2232

Enrollment Application

Welcome future student.  Pray, then please help us get to know you by completing this free, confidential application.

Full Name
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
E-Mail Address
Home Phone Date of Birth  
Cell Phone Gender Male Female  
Fax Number Marital Status  
High School Diploma Awarded By: Year & Major  
Associates Degree Awarded By: Year & Major  
Bachelors Degree Awarded By: Year & Major  
Masters Degree Awarded By: Year & Major  
Doctoral Degree Awarded By: Year & Major  
The date you became a Christian
Do you hold ministerial credentials?
If credentialed, when & by whom ?
Church Member?  Church Name: 
Do You Have A Felony Conviction? If so, describe below.
Spouse's Name (if applicable)
Your Current Occupation
Applying To Which Program :

Why do you want to become a counselor?

How do you know you were called into the counseling ministry?

What training in counseling have you had already?

Share your experience dealing with other people's spiritual and emotional issues...

Please share your immediate goals for your counseling ministry:

Do you plan to be involved with an existing ministry,
or are you considering establishing a counseling ministry?

Please share how you discovered Pastoral Counseling Center
 (Google, Yahoo, Charisma, Ministry Today, Bing,  etc.)...

Your remarks, questions, suggestions or anything else we should know...

Are you ready to begin?