Application Form

$50.00

To apply for consideration as a candidate to become a SMHP Certified Therapist or SMHP Certified Teacher, a SMHP Certified Instructor, or a ROTS Affiliate and SMHP Certified Instructor, please fill out the form and pay the fee.

For more information go to our Certification Information page.

School Name

Name *

Email *

Phone *

Credentials

Years of Experience

Years of School Based Experience

Home Address

School District

School Address

Day Phone

Mobile Phone

Upload Your Resume

(max file size 2 MB)

Check one of two to complete this form. *

When did you attend the webinar/class? *

Upload Your Essay

(max file size 2 MB)

Description

To apply for consideration as a candidate to become a SMHP Certified Therapist or SMHP Certified Teacher, a SMHP Certified Instructor, or a ROTS Affiliate and SMHP Certified Instructor, please fill out the form and pay the fee.

For more information go to our Certification Information page.