Board Application

I am willing to serve as*

President Elect (3 year term): Must have been on the CALPCC Board for at least one year.
Secretary (2 year term)
Board Member (3 year term)
Student/Intern Board Member (1 year term)

Information for the Nominating Committee

Check all that apply*

California Resident.
CALPCC member in good standing.
Clinical Members: California LPCC
Affilate Member (no CA LPCC)
Student/Intern Members: Enrolled in a minimum of 6 units of a graduate counseling program or registered, or in the process of registering, as a PCC Intern by October 1, 2018
Agree to attend monthly Board Conference Calls (second Friday of each month).
Agree to carry out the CALPCC mission.
Able to serve at least a 3 year term (if representing clinical, affiliate and emeritus members) or a 1 year term (if representing pre-licensed student/intern members)
Willing to serve as a Committee Chair, or Project Manager.
Willing to attend at least one monthly committee meeting, in addition to the monthly Board meeting, via conference call.

Information for the Ballot Statement

Name*

First Last

Email (For Internal Use Only)*

Enter Email Confirm Email

License*

If student/intern or Affiliate Member, please enter "none"

Employer*

If you are not currently employed, enter "none".

Current Job Title*

If you do not currently have a job title, enter "none".

Number of years of experience in the field of Counseling:*

Please enter a value between 0 and 50.

Please describe your interest in serving as a Board Director of CALPCC, as well as the skills and experience that you would bring to the Board: (limit 150 words)*

Past Board experience*

Resume (in pdf format)

Please upload your resume in pdf format

My Committee Preferences

Please find the committee descriptions on the nominations menu above. After reading the Committee descriptions, please indicate committees that you would be willing to chair and describe the skills/experience that would enable you to lead one of these committees.

First Choice Committee*

Skills/Experiences relevant to this committee

Second Choice Committee*

Skills/Experiences relevant to this committee

Third Choice Committee*

Skills/Experiences relevant to this committee