CBT Certification Application

The Biblical Christian Counseling Ministry, Inc.

Application — CBT Certification Program

Please complete every field below. When you click "Submit Application," your completed form will download to your computer and open a pre-addressed email to our office for you to attach your application and send to our office. See the note after you submit for the last quick step.
Personal Information
Family Information
Professional Information
Academic Background
Clinical or Pastoral Counseling Training
Counseling Background

1.Briefly describe your view of Christian Counseling. List any other certifications you have in counseling.

2.List the state counseling license(s) you presently hold.

3.Describe your present method of counseling.

4.How would you describe your present Bible knowledge?

5.Describe your call to counseling.

6.Describe your salvation and on-going spiritual development.

7.Why do you want to learn Cognitive Biblical Therapy?

Self-Assessment: Legal
Have you ever been disciplined by the church?
Are you listed on a sex offender registry?
Have you had a felony conviction?
Is there any reason you are not fit to be a biblical Christian counselor?
Self-Assessment: Professional
TraitVery Low
1–25%		Modest
25–50%		 Very Good
50–75%		Outstanding
75–90%		 Truly Exceptional
90–100%		Unable to
Judge
Self-Assessment: Personal
TraitVery Low
1–25%		Modest
25–50%		 Very Good
50–75%		Outstanding
75–90%		 Truly Exceptional
90–100%		Unable to
Judge
References

Please provide the information of three persons willing to complete an evaluation form on your behalf, including your pastor, a counseling professional, and a personal friend.

Reference 1

Reference 2

Reference 3

Please fill in your full name and email address before submitting.

Clicking submit downloads a completed text file (opens in Notepad) and opens a pre-addressed email to our office. Browsers will not let a webpage attach that file for you automatically — you'll just need to drag it into the email draft that opens, then hit send. The confirmation below walks you through it.

Almost done — one quick step left

  1. Your completed application, CBT-Application.txt, has just downloaded to your computer (check your Downloads folder — it opens in Notepad or any plain-text app).
  2. A new email addressed to gayle@thebccm.org should have opened in your email program, with the subject and a short message already filled in.
  3. Attach the file that just downloaded to that email, then click Send.