Play Therapy Interest Form

Please answer the questions below, to assess your eligibility for the course.

Please note: * (asterisk) Indicates a required field.

Contact Information

Name:
Address:

Educational/Licensure Requirements Information

SacState Graduate?:

Are you a graduate of the Sacramento State M.S. in Counseling program?

Working Counselor?:

Are you currently a working counselor?

Credential Sought:

Are you seeking to obtain credentialing as a: (select one)

A minimum 3.0 GPA is required for the program. What was your overall GPA in your counseling graduate degree?

Please note:
When applying to the program, you will be required to provide a copy of Licensure or Associate registration as an LPCC, LCSW, or MFT through the Board of Behavioral Sciences (or equivalent state licensing board), licensure or associate registration as a psychologist through the Board of Psychology (or equivalent state licensing board), OR possession of a valid Pupil Personnel Services credential through the California Commission on Teacher Credentialing (or equivalent state teacher credentialing board).
Also, a $30 application fee will be applied after registering in the program.

Privacy Policy:

The College of Continuing Education respects your right to privacy. Any information given to us when requesting course or program material will be used solely for the purpose of answering or responding to your request. We do not sell or otherwise distribute your personal information. We may, however, use it to provide you with advanced notices of our course offerings. If at any time you wish to be removed from our mailing lists, you may contact us and your request will be processed immediately.

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