Counselor Employment Application Counselor Employment Application Step 1 of 7 14% Name* First Last Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How did you hear about MyCounselor.Online?* Someone I Know Recommended You I Found You Online I Saw/Heard Your Advertisement Please Specify* For example: If you Google searched, what did you search for? If you followed a link from another site, what was the site? If a flyer or brochure, on what topic?CAPTCHA I understand…*Please indicate by checking the box by each statement that you understand and are able to meet these requirements for employment. If hired I will see clients online and possibly in-person. I will need to attend Team Meetings on Wednesday morning, 11-12:45 am CT. I must have or will soon complete a Masters degree in a counseling related field from an accredited institution. I intend to only see clients professionally (for fee) at MyCounselor.Online I am or will be state-licensed in a counseling related occupation such as Licensed Professional Counselor (LPC), Marriage and Family Therapist (MFT), Licensed Mental Health Counselor (LMHC), Licensed Clinical Social Worker (LCSW), Psychologist. What semester did you/will you complete your masters degree?*SP-21, FA-21, etc. Do you currently hold an unrestricted state license?* YES NO Unrestricted meaning able to practice without supervision (not provisional or intern).Please list your license state, type, and number* Example: MO LPC #55555555 What Date would you like to start?* MM slash DD slash YYYY Are you looking for Full-Time or Part-Time employment? Part-Time | 24 hrs/wk (16 hrs Therapy + 8 hrs Development) Full-Time | 40 hrs/wk (24hrs Therapy + 8 hrs Development) Written Structured InterviewIn this section, you’ll be asked a series of questions to help us get to know you better. Your answers are limited to 280 characters. Feel free to expand on your answers in the Letter of Introduction you attach later in the application, but do not write “see attached” here. Provide a concise summary answer. What adjectives reflect your impression of MyCounselor.Online and why you are applying.*What are the most important things we need to know about you?*Describe your DREAM JOB…* In your mind, how is ‘Christian' counseling different than secular?*Besides the Bible, what are your 5 favorite Christian thought / discipleship related books so far?*Describe your ministry experience.* What are your 5 favorite counseling related books so far?*List your most relevant previous therapy experience:*What counseling theories most resonate with your heart and reflect your approach to therapy?* Please attach: Letter of Introduction* Drop files here or Select files Accepted file types: jpg, png, pdf, tif, docx, doc, Max. file size: 50 MB. Please attach: Un-Official Transcripts* Drop files here or Select files Accepted file types: jpg, png, pdf, tif, docx, doc, Max. file size: 50 MB. Please attach: Resume* Drop files here or Select files Accepted file types: jpg, png, pdf, tif, docx, doc, Max. file size: 50 MB. Please attach: Current Photograph*Accepted file types: jpg, png, pdf, tif, docx, doc, Max. file size: 50 MB.Video UploadAfter submitting your application you will be redirected to a page where you can upload a video of you answering the question: “Why are you excited to work at MyCounselor.Online?” The video is intended to be informal. You can record and uploaded right from your phone. Please begin the video by introducing yourself and sharing your name. You will also receive a confirmation email with a link to the upload page in case you need to return to it from a different device.