Name
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First Name
Last Name
Email
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Phone
*
(###)
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What city and state are you located in?
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What school do you currently attend?
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Why did you decide to pursue a career in counseling?
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What degree/program are you completing?
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What is the starting date for your practicum or internship?
Which population are you most interested in working with?
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Select all that apply.
Do you have any specific goals for your career? If so, what are they?
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What is an area in which you are particularly interested in growing and becoming more educated?
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How do you feel about leading groups?
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Select one.
What is your biggest weakness as a professional?
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What is your biggest strength as a professional?
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What motivates you professionally?
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What motivates you personally?
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Which adjectives best describe you as a professional?
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What is your Enneagram number?
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What is your Myers-Briggs?
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How many hours does your program require for Practicum/Internship?
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How many weeks long is your semester?
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Is there anything else you'd like us to know about you?
