Ethics Presenter Application

Become an Ethics Presenter

Return to Ethics Page

The following information is required of all Ethics Presenters

Please take a moment to write a brief professional biography which includes your credentials and experience. This information is required on all submissions for presenters to ICA for CEU authorization. It is the hope of the Ethics committee to have these on file so that in the future early requests for CEU authorization can proceed more quickly and efficiently. Your cooperation is appreciated.

First Name:Last Name:

Address of office (or one you prefer for mailing):

City:State:Zip:

Phone Number:                    Cell Number:                      

FAX number (required):

Email address:

License designation:License Number:

Highest degree achieved:

Years of experience as a counselor (please include year of first licensure):

Areas of focus in your practice:

Academic positions held:

Any other items of interest that you wish to have included:

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Ethics Presenters:

• Have the opportunity to earn up to 5 CEUs in Ethics!
  

IMHCA P.O. Box 1217, Meridian, Idaho 83680