APPLICANT ASSESSMENT FORM

APPLICANT ASSESSMENT FORM
Candidate you are assessing:

First NameLast Name
The person named above is in the process of applying for our PreK-12 School Counselor or Mental Health Counseling licensure program and has asked you to assess the following areas:
The candidate possesses the personal characteristics necessary to be an effective counselor.

YesNo
The candidate possesses the potential necessary to be an effective counselor.

YesNo
Name:
Position:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Best Phone:

Area CodePhone Number
This assessment was completed by:
Date:
Should be Empty: