**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1
Do you have a minimum of a Bachelor's degree in a Health or Human Services counseling fieldORa Bachelor's degree in a program of study with a counseling emphasisAND1 credit in Alcohol and Drug Ethics? If yes, you must submit a copy of your transcripts documenting the completed coursework with your application.
Yes
No
2
In which field of study is your degree? If you do not have a degree, enter N/A.
3
Do you possess a current license as a Licensed Graduate Alcohol and Drug Counselor (LGADC) from the Maryland Board of Professional Counselors and Therapists?
Yes
No
4
If you answered Yes to the previous question, please provide the license number and expiration date in the box below. A copy of your current license or license verification should also accompany your application.