Enrol Now Online Enrolment Form Name* First Last Username*Email* Enter Email Confirm Email Password* Enter Password Confirm Password Strength indicator Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Nationality*Telephone Number*Sex*MaleFemaleOthersMarital Status*MarriedSingleDivorcedSeperatedOthersDate Of Birth (DOB) Ethnic Group*Religious Affiliation*Present OccupationPrevious Occupations (Describe Briefly): Professional Qualifications:Educational Qualifications. Please indicate courses, seminars or previous training/school programs you have attended*Are you working under practice supervision? (If yes, give details)*YesNoPlease give details here Practice involvement. Indicate your experience with: Pastoral or Clinical Have you been counseled?*YesNoIf yes, give brief summary: Course of Interest*CertificateDiplomaInstantShort-TermWhy did you decide to be a counselor?*CONDITIONS OF ENROLLMENT* 1. All course materials become the property of the student upon enrollment, notwithstanding, copyright material may not be used by others for whatever purposes. Course material may be used in group work only with the express permission of The Institute. 2. Course fees must be paid in American dollar or Nigerian Naira. Fees paid are not refundable. 3. A transfer to another course will always be considered but this may be subject to a nominal fee. 4. The Institute reserves the right to request references from applicants. 5. All applications are subject to approval from the Admissions Secretary before enrollment. 6. The Institute reserves the right to alter, substitute or amend course material or resources without prior notice. 7. The institute reserve the right to dismiss any student incase of bridge of contract. 8. Your statutory rights are not affected by these conditions of enrollment. NameThis field is for validation purposes and should be left unchanged. Δ