CRCC Emerging Leaders Network Interest Survey

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1. What is your name? (Required.)

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2. Please provide your preferred email address (if you are student, please provide a non-school email address). (Required.)

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3. Are you a CRC? If yes, please provide your CRC customer ID number. (Required.)

Yes

CRC customer ID number

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4. Where are you located? (Required.)

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5. Are you currently a graduate student? (Required.)

Yes

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6. What is your master's degree in? (Required.)

Rehabilitation Counseling

Clinical Rehabilitation Counseling

Additions/Substance Abuse Counseling

School/Guidance Counseling

Mental Health Counseling

Counseling Psychology

Marriage and Family Counseling/Therapy

Social Work

Other (please specify)

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7. Where did you earn your master's degree? (Required.)

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8. When did you graduate from your master's program (or anticipated graduation date)? (Required.)

Graduation date (or anticipated graduation date)

Date

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9. What is your undergraduate degree in? (Required.)

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10. Where did you earn your undergraduate degree? (Required.)

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11. What is your current practice setting? Select all that apply. (Required.)

Student

Education

Health Sector

Community Rehabilitation Programs

VHA/VBA

State VR

Government Agency

Private Practice

Forensics

Social Security

Lifecare Planning

Other (please specify)

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12. What areas in the rehabilitation counseling profession would you like to discuss within the Emerging Leaders Network (i.e. challenges, strengths, etc.) (Required.)

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13. What topics of advocacy are you interested in? Select all that apply. (Required.)

Legislation

Public awareness

Disability equity

Employment accommodations

Licensure

DEI

Other (please specify)

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14. What topics would you like to explore within the Emerging Leaders Network? Select all that apply. (Required.)

Work settings

Assessments/Resources for clients

Continuing education & training

Mentorship

Networking events

Scopes of practice within the Rehabilitation Counseling field

Other (please specify)

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15. Are you interested in a leadership role within the Emerging Leaders Network? (Required.)

Yes

CRCC Emerging Leaders Network Interest Survey

Question Title

* 1. What is your name? (Required.)

Question Title

* 2. Please provide your preferred email address (if you are student, please provide a non-school email address). (Required.)

Question Title

* 3. Are you a CRC? If yes, please provide your CRC customer ID number. (Required.)

Question Title

* 4. Where are you located? (Required.)

Question Title

* 5. Are you currently a graduate student? (Required.)

Question Title

* 6. What is your master's degree in? (Required.)

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* 7. Where did you earn your master's degree? (Required.)

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* 8. When did you graduate from your master's program (or anticipated graduation date)? (Required.)

Question Title

* 9. What is your undergraduate degree in? (Required.)

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* 10. Where did you earn your undergraduate degree? (Required.)

Question Title

* 11. What is your current practice setting? Select all that apply. (Required.)

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* 12. What areas in the rehabilitation counseling profession would you like to discuss within the Emerging Leaders Network (i.e. challenges, strengths, etc.) (Required.)

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* 13. What topics of advocacy are you interested in? Select all that apply. (Required.)

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* 14. What topics would you like to explore within the Emerging Leaders Network? Select all that apply. (Required.)

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* 15. Are you interested in a leadership role within the Emerging Leaders Network? (Required.)

1. What is your name? (Required.)

2. Please provide your preferred email address (if you are student, please provide a non-school email address). (Required.)

3. Are you a CRC? If yes, please provide your CRC customer ID number. (Required.)

4. Where are you located? (Required.)

5. Are you currently a graduate student? (Required.)

6. What is your master's degree in? (Required.)

7. Where did you earn your master's degree? (Required.)

8. When did you graduate from your master's program (or anticipated graduation date)? (Required.)

9. What is your undergraduate degree in? (Required.)

10. Where did you earn your undergraduate degree? (Required.)

11. What is your current practice setting? Select all that apply. (Required.)

12. What areas in the rehabilitation counseling profession would you like to discuss within the Emerging Leaders Network (i.e. challenges, strengths, etc.) (Required.)

13. What topics of advocacy are you interested in? Select all that apply. (Required.)

14. What topics would you like to explore within the Emerging Leaders Network? Select all that apply. (Required.)

15. Are you interested in a leadership role within the Emerging Leaders Network? (Required.)