New Counselor Institute (NCI) Registration

MO 500-3139 (02-18)

Instructions

New Counselor Institute (NCI) is designed for those entering school counseling positions with:

A Temporary Authorization Certificate
An Alternative Certification with no or one year of school counseling experience
Recent graduation from a school counseling master’s program and 0-1 years of counseling experience
No public school experience

Priorities for acceptance will be based on the bulleted list above. Local administrative approval is required (with electronic signature).

A $25.00 nonrefundable registration fee is required for ALL participants.

Date: July 9-12, 2018

Location: Holiday Inn Executive Center, Columbia, MO

QUESTIONS: Contact School Counseling at 573-751-4383
Registration deadline is June 18. Registration will be subject to availability after June 18.

Question Title

* Personal Contact Information

Name:

Home Mailing Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Email Address:

Question Title

* School Information

Local Educational Agency (LEA) (Where registrant will be working):

County-District Code:

School Mailing Address:

School Code:

City:

State:

Zip:

School Phone:

Question Title

* Grade Level Assignment for the 2018/19 School Year:

Elementary (Grades K-6)

Middle School (Grades 6-8)

High School (Grades 9-12)

Secondary (Grades 7-12)

K-12

Area Career Center

The Department of Elementary and Secondary Education does not discriminate on the basis of race, color, religion, gender, national origin, age, or disability in its programs and activities. Inquiries related to Department programs and to the location of services, activities, and facilities that are accessible by person with disabilities may be directed to the Jefferson State Office Building, Office of the General Counsel, Coordinator - Civil Rights Compliance (Title VI/Title IX/504/ADA/Age Act), 6th Floor, Jefferson Street, P.O. Box 480, Jefferson City, MO 65102-0480; telephone number 573-526-4757 or TTY 800-735-2966; email civilrights@dese.mo.gov.