Application for Crisis Specialist Exam Only

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* 1. First and Last Name

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* 2. E-mail address

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* 3. Phone Number

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* 4. Birthdate

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* 5. Organization Name

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* 6. Is your organization a member of the American Association of Suicidology?

Yes

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* 7. Enter your education history (Post high school. Begin with most recent).

Institution

City/State

Dates Attended

Degree/Certification

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* 8. Enter your education history (Post high school. Begin with most recent).

Institution

City/State

Dates Attended

Degree/Certification

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* 9. Enter your education history (Post high school. Begin with most recent).

Institution

City/State

Dates Attended

Degree/Certification

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* 10. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention). 3 months full-time or 6 months part-time is required.

Agency

Title

City/State/Province

Dates

# of weeks

# of hours each week doing crisis intervention

Total hours performing direct crisis work in this position

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* 11. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention).

Agency

Title

City/State/Province

Dates

# of weeks

# of hours each week doing crisis intervention

Total hours performing direct crisis work in this position

Question Title

* 12. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention).

Agency

Title

City/State/Province

Dates

# of weeks

# of hours each week doing crisis intervention

Total hours performing direct crisis work in this position

Question Title

* 13. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention).

Agency

Title

City/State/Province

Dates

# of weeks

# of hours each week doing crisis intervention

Total hours performing direct crisis work in this position

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* 14. Upload proof of 40hrs Crisis/Clinical Training here. A minimum of 40hrs of training (within the last 3 years). This 40hrs of training can be relevant academic coursework, workshops, seminars, or conferences. Academic coursework will be considered if transcripts are uploaded. All training must have occurred within the last 3 years.

Upload your Crisis/Clinical Training log and/or transcripts here.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 15. Upload a letter of support from someone who is directly acquainted with your work.

Upload file

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 16. Resume or CV upload

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 17. Upload the certificate of attendance from your AAS Crisis Specialist Training. Completion of the AAS Crisis Specialist Training (within the last 12 months) is required.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 18. I understand payment is non-refundable and non-transferrable.

Yes

Application for Crisis Specialist Exam Only

Question Title

* 1. First and Last Name

Question Title

* 2. E-mail address

Question Title

* 3. Phone Number

Question Title

* 4. Birthdate

Question Title

* 5. Organization Name

Question Title

* 6. Is your organization a member of the American Association of Suicidology?

Question Title

* 7. Enter your education history (Post high school. Begin with most recent).

Question Title

* 8. Enter your education history (Post high school. Begin with most recent).

Question Title

* 9. Enter your education history (Post high school. Begin with most recent).

Question Title

* 10. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention). 3 months full-time or 6 months part-time is required.

Question Title

* 11. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention).

Question Title

* 12. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention).

Question Title

* 13. Enter your clinical experience in direct crisis work. (Any volunteer or paid position you have held to calculate your total hours performing crisis intervention).

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* 15. Upload a letter of support from someone who is directly acquainted with your work.

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* 16. Resume or CV upload

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* 17. Upload the certificate of attendance from your AAS Crisis Specialist Training. Completion of the AAS Crisis Specialist Training (within the last 12 months) is required.

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* 18. I understand payment is non-refundable and non-transferrable.

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* 19. How did you learn of our trainings? (social media, professional organization, membership call, colleague/friend, membership email, etc)