Certified Crisis Helpline Specialist Exam Application

Thank you for your interest in the International Council for Helplines Certified Crisis Helpline Specialist Exam.  Please complete the application below.  Once we have received your application, recommendation and exam fee, we will send you the test instructions and a link to the exam.  If you have any questions, please email gail@councilforhelplines.org
Please list your name below as you would like it printed on your certificate.
Exam Fee *
If your exam fee is not pre-paid by your organization, an invoice for the exam fee plus payment options will be emailed to you.
Please check here if you would like to pay by credit card:
How would you like to receive your certified helpline specialist certificate? *
Does International Council for Helplines (ICH) have your permission to include your name and organization on the list of Certified Crisis Helpline Specialists that is located on the ICH website? *
Does International Council for Helplines (ICH) have your permission to publish your name in a monthly ICH Newsletter as a new certified crisis helpline specialist once you pass the exam? This newsletter is emailed to all ICH members. *
Please check here if you require any type of accommodation to take the exam.

Test Taking Attestation Statement

By signing below, I attest that I will take the Certified Crisis Helpline Specialist exam in a private location with only myself present and have no one else take the test on my behalf.  I will not use any resources while taking the exam, including books, notes or online information.  Since some of the material contained in the exam is used for future exam administrations, I will refrain from sharing the questions or specific content on the exam to applicants, future applicants or any other persons.  

Electronic Signature (First Name/Last Name) *