Crisis Helpline Specialist Re-certification Exam Application

Thank you for your interest in the International Council for Helplines Re-certification Crisis Helpline Specialist Exam. Please complete the application below. Once we have received your application and exam fee, we will send you the test instructions and a link to the re-certification 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.

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Name of Organization *

Position Title *

What has been your crisis helpline experience since becoming certified? *

Exam Fee *

Individual - International Council for Helplines member organization ($25)

Individual - Non-member organization ($45)

Please mail your fee noting your name and Crisis Helpline Specialist Re-certification 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.

Pay by credit card

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

By mail

By email

Both mail and email

Does International Council for Helplines have your permission to publish your name and organization as a certified Crisis Helpline Specialist? *

Yes

No

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 * +