Online Program Application

Your Information

Prefix*

First Name*

Last Name*

Suffix

Preferred First Name

Maiden Name/Alternate Last Name

Gender*

Female

Male

Birthdate*

Email Address*

Mobile Phone Number*

Can Grace College send you important updates via text?* (Standard messaging rates apply.)

Yes

Permanent Address*

Country

Street

City

Region

Postal Code

Is your mailing address the same as your permanent address?*

Yes

Mailing Address

Country

Street

City

Region

Postal Code

Are you seeking a fellowship with an industry partner?*

Yes

When will you graduate with your bachelor's degree?*

Describe how you will balance your graduate coursework with your undergraduate courses, personal life, extracurriculars, etc.:*

In order to complete your application, an Advisor Recommendation is required. Provide your advisor's email address, and a recommendation request will be sent to them automatically.*

A cross-cultural field experience is required of all traditional undergraduate students at Grace College.

Have you taken a Go Encounter trip, Third Culture/International Student course, or CCFE Independent trip?*

Yes

Great! It is good to complete this graduation requirement prior to beginning a dual degree plan.

Which do you plan to pursue in order to complete your cross-cultural requirement?*
(It is best to complete this graduation requirement prior to beginning the dual degree plan.)

CCFE Independent Trip

Go Encounter Trip

Third Culture / International Student option

When do you plan to take your trip?*
Remember: this requirement must be completed or neither degree can be awarded.

I acknowledge that I have been notified that the cross-cultural field experience is a requirement for my undergraduate degree. Further, I acknowledge that I need to complete it prior to, or during my final undergraduate term or it will delay the completion of both my undergraduate and graduate degrees. I understand that December trips are considered to be in the Fall term, Spring break trips are considered to be Spring term and May trips are in the Summer term.

Yes

Do you plan to teach in Indiana?*

Yes

Desired Teaching Content Area:*

Have you filled out the Free Application of Federal Student Aid (FAFSA)?*

Yes

Do you intend to?*

Yes

What factors influenced your decision to apply for this program?

Please describe yourself as a student, a professional, and a citizen.*

Educational Experience

Have you ever been refused admission to or dismissed from an institution of higher education?*

Yes

Please explain:*

Have you been enrolled in another graduate clinical mental health counseling program?*

Yes

Please list school(s) and program(s):*

Will you be transferring graduate credits from a CACREP accredited program?*

Yes

High School

High School Name*

Country

City

State

Cumulative GPA

Graduation Year*

Have you enrolled in any college-level courses?

Yes

DeleteSchool _ID_
Please list all colleges/institutions you have attended:
College/Seminary Name* Institution CEEB (hidden) Level of Study* Country City State Attended from:* Attended from:* Attended to:* Attended to:* Degree* Other degree: Major* Number of credits earned* Number of credits earned GPA*

Add School

DeleteEmployer _ID_
Work Experience
Employer* Position/Job Title* Start Date* Start Date* End Date End Date

Add Employer

Other Experience

Please list any experiences in counseling, helping others, missions, or other occurrences you'd like to share.

Add experience

Yes

DeleteExperience _ID_
Counseling Experience
Company/Organization Description Start Date Start Date End Date End Date

Add experience

Church Information

Your Denomination*

Other Denomination

If your church is not listed below, please add your church here and then select it from the list below.

Name of your Church*

Professional Reference

This program requires a Professional Reference for admission. Please provide the name and email for your reference.

This person should be a recent (within the last year) employer, instructor, or supervisor of one year or longer and cannot be a relative.
If you are currently working on your Bachelor's degree or have graduated in the last year, you may use have a faculty member complete this reference.

Reference First Name

Reference Last Name

Reference Email

Pastor/Spiritual Reference

Grace College may contact this person for a spiritual life reference.

First Name*

Last Name*

Email*

Phone Number

Testimony and Doctrinal Statement

I have accepted Jesus as my Lord and Savior.*

Yes

Please describe your relationship with Jesus Christ as Savior and Lord. Describe how and when that relationship began and the influences that are contributing to your spiritual development.*

Please read our Covenant of Faith statement.

I have read the Covenant of Faith, and my convictions are in agreement with the doctrines stated in it.*

Yes

My convictions differ in the following way(s):*

Testimony and Purpose Statement

I have accepted Jesus as my Lord and Savior.*

Yes

Please describe your relationship with Jesus Christ as Savior and Lord. Describe how and when that relationship began and the influences that are contributing to your spiritual development.*

Department of Graduate Counseling Purpose Statement
The DoGC is committed to providing graduate level programming that equips students to be scripturally grounded, professionally skilled, and interpersonally competent as they actively engage in the counseling profession and its related ministries. The purpose of the CMHC degree is to prepare students for future licensure in clinical mental health counseling.

In 300-350 words, please provide a clear, thorough response to the following question, as it will also be reviewed as a writing sample. How does our program's purpose statement align with your career goals?*

Licensure Information

Obtaining licensure is necessary to practice as a clinical mental health counselor. If you desire to practice outside of Indiana, you need to research your state's licensing requirements. State licensing authorities review many issues including your educational background before granting individuals licensure. It is essential to review all of the state's educational requirements prior to starting your studies.

At Grace College, we offer both residential and hybrid M.A. in Clinical Mental Health Counseling degrees that help prepare learners to work with hurting individuals. However, Grace cannot ensure any learner will obtain a state license regardless of delivery format. But we hope that we can provide you with as many tools as we can to help you determine if the program you are considering will allow you to apply for the license you need. Licensing requirements differ from state to state and change over time. To assist you in your research we have provided some guidelines and resources listed below. An individual who wishes to become licensed is solely responsible for knowing and complying with the licensing requirements for the state in which s/he plans to practice.

Licensure Information

Do you understand the statement above?*

Yes

Legal Questionnaire

Have you ever been subject to court probation or disciplinary action?*

Yes

Legal Questionnaire

Failure to disclose criminal history on the application will result in an automatic denial or rescinding of admission.

Have you ever been convicted of a criminal offense (felony or misdemeanor, except for minor traffic violations)? You will need to answer 'Yes' if you have entered into a plea agreement, including a deferred sentence or deferred judgment arrangement, in connection with a criminal charge.*

Yes

Have you ever been convicted of a sexual offense, offense relating to children or crime of violence (that is not covered in the question above)?*

Yes

Have you been reported to a social services agency, law enforcement authority, child abuse registry or similar organization regarding abuse or misconduct involving children?*

Yes

What is the nature of your charge/offense?*

When did the situation occur?*

Were there multiple offenses?*

Did you complete the resulting sanctions/consequences?*

Explain what you've learned from this situation.*

Lifestyle Commitment and Notice of Nondiscrimination

I acknowledge that Grace College is currently in the process of receiving final approval for the Transition to Teaching program.

Please read our Notice of Nondiscrimination.

I agree to abide by the Lifestyle Commitment while on campus or engaged in any Grace academic or extracurricular activities.

I certify that all information given on this application is complete and accurate. I understand that falsification of any part of this application or any behavior contrary to Grace’s mission or values may result in rescinding of admission, dismissal from the college or other appropriate disciplinary action. I also grant my school(s) permission to release my transcript(s) to Grace.*

I agree

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Online Program Application

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Failure to disclose criminal history on the application will result in an automatic denial or rescinding of admission.