ACCC Registration Form

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Please complete the following questions in order to register for career counseling services at the Adult Career Counseling Center.

Last Name *

First Name *

Phone Number *

Please pick a phone number that is best for a career advisor to contact you with to set up an appointment

Email *

Please select an email that will be best for a career advisor to contact you with

Enter a brief description of why you are seeking ACCC services: *

Do you prefer to meet in person or virtually? *

in person

virtually

no preference

Please Indicate days and times you would be available for an appointment. *

ACCC hours of operation are: Monday-Thursday 9:00AM-9:00PM and Friday-Saturday 9:00AM-3:00PM

How did you find out about the center? *

Which type of services do you wish to receive? *

Note: Group sessions focus on the same material as an individual session only in a 4-6 week group format

Individual Sessions

Group Sessions

I am willing to do either individual or group

必填

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