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 info@councilforhelplines.org
 
Please list your name below as you would like it printed on your certificate.
Exam Fee *
Please mail your fee noting your name and Crisis Helpline Specialist Exam to:
International Council for Helplines - Finance
6339 Charlotte Pike #551
Nashville, TN  37209
If you would prefer to pay by credit card, check below and a link to the International Council for Helplines PayPal account will be emailed to you.
Does International Council for Helplines have your permission to publish your name and organization as a certified Crisis Helpline Specialist? *
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.  

I will also provide the name, title and contact information of a person in a managerial position within my organization to attest and ensure that I meet the test taking requirements stated above.
Electronic Signature (First Name/Last Name) *
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