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.

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Country *

Phone Number *

Email Address *

Name of Organization *

Position Title *

Crisis Helpline Specialist Training - list specific trainings, workshops, conferences, seminars that meet International Council for Helplines training core competencies. If you are from an International Council for Helplines accredited organization, you only need to state the name of the organization and the month/year of your initial training. *

Crisis Helpline Experience - provide specific role information demonstrating you have met the time in role requirement including the name of the organization, your title, dates of service and total # of direct service hours. *

Provide the name and contact information for the person completing your professional reference. Please include an email so the reference link can be sent. *

Exam Fee *

Individual - International Council for Helplines member organization ($35)

Individual - Non-member organization ($65)

Pre-paid exam fee by my organization ($0)

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:

Pay by credit card

How would you like to receive your certified helpline specialist certificate? *

By mail

By email

Both my mail and email

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? *

Yes

No

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. *

Yes

No

How did you hear about the International Council for Helplines Crisis Helpline Specialist Exam? *

Please check here if you require any type of accommodation to take the exam.

Yes, I require an accommodation

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) *

clear

Date * +