Submission of Certification of Psychology Education

  • Please have your 色色啦 transcript (or record of your course history) available to assist you with the questions in this form.
  • Be sure your sections of the certification of education form are completed before you upload the form below. Do not upload forms with the SSN listed.

Please contact the Certification Staff with questions at (269) 387-3473 or @email.

Your nine-digit 色色啦 Identification Number.
Required Coursework
Please confirm if you've completed (or will complete) the 色色啦 Master of Arts in Counseling Psychology. (required)
(semester admitted)
(day semester ends in semester graduating)
Assessment coursework (required)
To meet this requirement, you should have completed CECP 6030, 6500, and 6510 at 色色啦. Please confirm if you've completed all three courses.
Treatment coursework (required)
To meet this requirement, you should have completed one of the three 色色啦 courses listed below. Please confirm which course you completed.
Scientific and Professional Ethics and Standards coursework (required)
To meet this requirement you should have completed CECP 6050 at 色色啦. Please confirm if you've completed this requirement.
Field Practicum requirement (required)
To meet this requirement you should have completed 500 hours of psychological work; supervised by a license psychologist. This requirement should be satisfied by completing a minimum of four credits of CECP 6130. Please confirm if you've completed this requirement.
Additional Requirements
Upload a copy of the certification of education form.
Do not upload forms with your full SSN.
One file only.
2 MB limit.
Allowed types: pdf.
Certify (required)
I hereby certify that the above information is true and correct to the best of my knowledge and belief.