IC3 Institute - Application for Admission
PERSONAL INFORMATION
Full name *
Your answer
What is your e-mail address? *
Please, list an e-mail address that you do access frequently, and be sure to check it regularly -- this will be the e-mail address that IC3 will use to contact you.
Your answer
Phone number *
Please, remember to add your country and area code.
Your answer
Address *
Your answer
Country of residence *
Your answer
City of residence *
Your answer
Postal code *
Your answer
Gender *
WORKPLACE INFORMATION
School name *
Please, add the full name of the school at which you currently work.
Your answer
School's website
Your answer
School's phone number *
Your answer
School's address *
Your answer
Is your high school program from grade 9-12? *
Is there a formal career and college counseling program setup in the school? *
TOTAL NUMBER OF STUDENTS IN EACH GRADE
Grade 9 *
Your answer
Grade 10 *
Your answer
Grade 11 *
Your answer
Grade 12 *
Your answer
PROFESSIONAL INFORMATION
Are you a full time employee of your school? *
What is your current role in the school? *
Please, check all that apply.
Required
Are you actively guiding students (career and/or college guidance)? *
If you answered yes to the question above, how many years have you been counseling students?
Your answer
How long have you been working in a high school setting? *
Your answer
INSIGHT QUESTIONS
Have you received permission from your employer to attend the 4 weeks of residential training? *
You must attend a week of residential training every quarter (fall 2019 through spring 2020)
Briefly describe the current counseling challenges you're facing. *
Please, explain your answer in 750 characters (about 150 words).
Your answer
Briefly mention what you'd like to see in the program to help you overcome the challenges you're facing. *
Please, explain your answer in 500 characters (about 100 words).
Your answer
Why do you wish to participate in the IC3 Institute training? *
Please, write your letter of intent in no more than 1500 characters (about 300 words).
Your answer
Have you attended any of the following IC3 events (tick all that apply) *
Required
TERMS AND CONDITIONS
Candidates must confirm and understand all of the following Terms and Conditions in order to apply to the IC3 Institute.

The Terms and Conditions include 5 yes/no questions on the following pages. Candidates must answer all 5 questions affirmatively for eligibility to complete this application for the IC3 Institute.

I confirm that I am a full-time counselor/teacher at a high school, and I have permission from my school to participate. *
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