Form 08-4403 - Professional Counselor Licensure Application - Juneau - 2013 Page 2
Download a blank fillable Form 08-4403 - Professional Counselor Licensure Application - Juneau - 2013 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 08-4403 - Professional Counselor Licensure Application - Juneau - 2013 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18If the institution is not regionally accredited, per 12 AAC 62.120, the degree must have included course work in
at least eight specific subject areas. To assist the board in review of your education, please complete the
Educational Course Work Check Sheet and return with your application (form 08-4403d).
If your graduate degree is in a related field, not counseling, you must complete the Educational Course Work
Check Sheet (form 08-4403d). “Related field” includes psychology, marital and family therapy, social work, and
applied behavioral science.
You must have a total of 60 graduate semester hours in counseling during or after earning the master’s degree.
An applicant who has not obtained enough graduate semester hours in the applicant’s earned master’s degree
in counseling or a related professional field to meet the 60 graduate semester hours required under AS
08.29.110(a)(5)(B) may obtain the additional graduate semester hours needed to meet that requirement from an
accredited program, either online or at an institution.
4.
Submit verification of successfully having passed the National Counselor Examination for Licensure and
Certification (NCE) within the last three years before the date of application administered by National Board
for Certified Counselors, Inc. (NBCC). The exam scores must be sent directly to the Division of Corporations,
Business and Professional Licensing from the NBCC. Candidates wishing to sit for this examination will need
to contact the NBCC directly to schedule the examination. To obtain information regarding the examination,
please contact:
National Board for Certified Counselors, Inc.
3 Terrace Way, Suite D
Greensboro, North Carolina 27403-3660
(336) 547-0607
5.
Verification of having completed at least 3,000 hours of supervised experience in the practice of professional
counseling performed over a period of at least two years under the supervision of a supervisor approved by the
board (form 08-4403c). This experience must be completed after having received your degree. You must verify
that you have had at least 1,000 hours of direct counseling with individuals, couples, families, or groups and at
least 100 hours of face-to-face supervision.
Your supervisor must be approved by the board, in accordance with 12 AAC 62.200, before supervision
begins. This supervision must come from a licensed professional counselor, licensed clinical social worker,
licensed marital and family therapist, licensed psychologist, licensed psychological associate, licensed
physician, licensed psychiatrist, or licensed advanced nurse practitioner who is certified to provide psychiatric or
mental health services.
6.
Each applicant is to submit a complete report of criminal justice information under AS 12.62.005 – AS 12.62.200
for Alaska. The Alaska report can be obtained by contacting the Department of Public Safety, Alaska State
Troopers at any of the following locations listed on page 4 and 5.
In addition to the Alaska reports, if a state other than Alaska is your primary state of residence you must submit
an equivalent report from your state of residency. Nonresident applicants will need to contact your local law
enforcement office to obtain a complete report of criminal justice information.
Please Note: If forms are not legible, they will be returned
.
(Rev. 03/04/13)
08-4403
Page 2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal