Training Application

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HOLISTIC CHRISTIAN THERAPIES

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Christian Counseling Training Application

Application

* Indicates required field

Name *

First

Last

Age *

Marital or Relationship Status *

How many children do you have? *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Why are you interested in becoming a Christian Counselor? *

Are you a Christian? *

Yes No

Are you interested in having your own private counseling ministry? *

Yes No

Are you interested in ministering to a particular group of people and/or in a specific area of need (i.e., addicts, young men, married couples, eating disorders, etc.)? *

Are you looking to make this your primary source of income? *

Yes No

Have you ever had counseling yourself? *

Yes No

Have people told you that you are a good listener? *

Yes No

How many hours per week would you be able to dedicate to your counseling ministry? *

Please list all previous counseling training and/or certifications that you have received: *

Have you read the Bible? Describe your relationship with the word of God: *

Do you only feel good if you are doing something productive or achieving something? *

Yes No

When someone questions you or disagrees with you, do you become deeply irritated, angry, or argumentative? *

Yes No

Do you struggle with feeling far from God? *

Yes No

Do you find yourself trying to please God with your behavior? *

Yes No

Is your worth and value based on how well you do something? *

Yes No

Do you constantly deal with fear in the form of anxiety, stress, and worry? *

Yes No

Do you have a hard time figuring out where you are headed in life? *

Yes No

Do you feel a need to be right in discussions? *

Yes No

Do you struggle with addictive habits? *

Yes No

Check all manifestations that currently apply to you: *

Insecurity Identity issues, Lack of identity Performance based living Constant busyness Identity confusion Chronic emotional woundedness Fear, anxiety, worry Mental illness struggles Relational walls or masks Constant relationship separation Twisted communication Relational strife Blaming (i.e., not my fault) Relationship sabotage Constant limitations in life Always feeling ignored/overlooked Bitterness, resentment, and anger A hurt that keeps repeating Discouragement/Depression Feeling separated from God/Others Rejecting others before you are rejected People pleasing tendencies False responsibility Excessive striving and overworking Perfectionism Excessive neediness Excessive need for validation Excessive need for affirmation Excessive attention getting Envy and Jealousy All forms of addictions Condemnation Religious legalism Feeling like an outsider Guilt and shame Self-pity Victim based thinking Hopelessness

Check all tendencies that currently apply to you: *

Low self-esteem People pleasing tendencies Poor boundaries Reactivity Caretaking (verses caregiving) Controlling Perfectionism Dysfunctional communication Difficulty expressing needs Obsessiveness Painful emotions (can't process or let go) Addiction tendencies

Is there anything else you think I should know about you that would qualify you as a Christian Counselor? *

The cost for this training is $1250, plus the cost of books and other course materials. Are you financially able to pay for this training? *

Yes No

Please Note: Only approved and qualified applicants will be invited to participate in the training course. I will contact you shortly to let you know if you have been approved and to discuss next steps.

Submit

Contact Information
Stephanie Stanton, H.H.C.
Phone/Text: 201-892-3959
Email: stephmastro@gmail.com

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