Soul Care Ministries International, Inc.

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1 Soul Care Ministries International, Inc. A Certified Academic Institution of the National Christian Counselors Association Equipping Christian Counselors for Works of Service 1 ( ), Ext 3 Below is a checklist of enrollment and program requirements: 1. Review and select a Program or Course of Study 2. Print the Full Enrollment Form (attached) for mailing or scanning/ ing. 3. Pay Enrollment Fee (Check, Money Order or PayPal for $75 Enrollment Fee) ~or ~ Save $50 by enrolling in the first course w/ a reduced enrollment fee of only $25 (Check, Money Order or PayPal for $335). Checks/Money Orders are to be made payable to Soul Care Ministries International, Inc (request an invoice for this option if paying by PayPal ). PayPal instructions can be found at: /n-c-c-a-program/n-c-c-a-program-tuition-and-fees 4. Complete Additional Requirements (Before/After Enrollment): You will be prompted early in Phase I to provide the balance of the enrollment documentation requirements. In any event, all requirements must be completed by the end of Phase I. It is recommended that you provide as much of the following, as possible, at the time of application. 1. A copy of the highest diploma, certificate or degree earned and related transcript. 2. A current resume' including any background in counseling or areas of interest in counseling and a recent photo. 3. Proof of Ordination or Minister's License in the form of a photocopy or official letter (not required for certification only program; required prior to enrolling in Phase II of the training program). 4. Three reference forms (provided by the N.C.C.A. with the first course). 5. A letter of reference from your pastor or an elder in your church. 6. Other documentation, as needed. NOTE: We will not recommend anyone for certification or license whose enrollment submission is not complete. All licensing candidates are subject to a National Background Check by the N.C.C.A.

2 N.C.C.A. Enrollment Agreement Soul Care Ministries International, Inc. is dedicated to providing quality training for Christian Counselors. Our training is available to Clergy and Lay Ministers who are seeking to expand or begin their counseling ministry. Please Print, Read, Sign and Scan/ , Fax or Mail this Enrollment Agreement, Responses to the Six (6) Questions (see page 4) and remit a check, money order or PayPal payment for $75 (Enrollment Fee) or $335 (Enrollment Fee + Discounted First Course Tuition including S&H via requesting a PayPal Invoice). Checks or Money Orders are to be made payable to Soul Care Ministries International, Inc. Soul Care Ministries International, Inc. c/o SCM Institute Attn: Dr. Linda H. King, President/Chief Ministry Officer 3535 Peachtree Road, # Atlanta, GA I wish to enroll in the following program (Check One): N.C.C.A. Program #1: Certification Only N.C.C.A. Program #1: Licensing Only N.C.C.A. Program #2: License + AA/BA/MA Degree N.C.C.A. Program #3: License + BA/MA Degree Program N.C.C.A. Program #4: License + MA Degree Program N.C.C.A. Program #5: License + PhD Degree Program N.C.C.A. Program #6: License + Optional 2d Doctorate Degree Program I wish to enroll in the following program (Check One Above and Check Below): SCM Institute N.C.C.A. Program #7: Our Signature N.C.C.A. Program Name Address City State Zip: Work Phone #: Home Phone #: Mobile Phone #: Fax #: Social Security Number: ### - ## - (at this time, last four digits only) Date of Birth: (##/##/19##) 2 of 5 P a g e

3 Address: Gender: (Male) (Female) U.S.P.S. Shipping Address: (If Different From Above): PLEASE COMPLETE THE FOLLOWING STATEMENTS: I have been a Christian for years. I graduated from high school in (Year) Did you graduate from college? Yes No If yes, please provide year, degree and college: Do you hold a Master's Degree? Yes No Name of College? What was your Major? Doctorate Degree? Yes No Name of College? What was your major? Have you ever been convicted of a felony? Yes No If yes, please explain in detail on a separate sheet of paper and attach to this enrollment form. Are you a licensed, commissioned or ordained minister? Yes No Year licensed/commissioned/ordained: Denomination: My denominational preference is: My current occupation is: My spouse's name is: 3 of 5 P a g e

4 QUESTIONNAIRE FOR ENROLLMENT (SUBMIT RESPONSES WITH YOUR ENROLLMENT) Please respond (on separate sheet of paper) and attach to this enrollment form. 1. Why do you want to be a counselor? 2. What formal/informal training in counseling have you had? 3. Why do you believe that this program will be of benefit to you? 4. Do you have experience in dealing with people with spiritual or emotional problems? 5. What are your goals for a counseling ministry? 6. How do you know that you are called/suited for the counseling ministry? TUTION AND FEES Tuition and fees are specific to the N.C.C.A. program selected. Tuition and fees are outlined in our N.C.C.A. Program Catalog and is student is provided with a prospectus. REFUND POLICY Soul Care Ministries International, Inc. is more than fair to the candidate who enrolls in the program and then, for some reason, needs to discontinue his or her candidacy. We do not believe that an individual should be charged for a service or for training not received. Therefore, we exceed normal standards with regard to fairness of our students as outlined. The enrollment fee will be totally refunded if the applicant is not admitted into the training program by the Evaluation Committee. Once accepted as a candidate, the enrollment fee is non-refundable. If a course is returned to the SCM Institute in good (resale) condition within fifteen (15) days of the date it was shipped, the tuition for the course, less a $95 restocking fee will be refunded within thirty (30) days from receipt of the returned course materials. N.C.C.A. Handling Fees, Shipping Cost and Practicum Fees will not be refunded unless cancellation is prior to commencement of those services. PLEASE TELL US HOW YOU WERE INTRODUCED TO: Soul Care Ministries International, Inc and the SCM Institute I previously completed N.C.C.A. courses through another source: I learned about the program via (Check One): Ad Radio LinkedIn Facebook Christian Magazine Internet I was referred by (Name of Individual) Other (Please Specify): 4 of 5 P a g e

5 METHOD OF PAYMENT: Personal Check, Bank Check, Money Order or Credit Card vai PayPal I am remitting $75.00 for Enrollment Only. I elect to pay for my first course separately. I am remitting $ which covers Enrollment, Shipping/Handling and a discount on my first course. (Recommended) Checks or Money Orders are to be made payable to Soul Care Ministries International, Inc. PayPal instructions can be found at PAYMENT INFORMATION Once enrolled, candidates will be required to pay for their courses and fees when due, as they go through the program. Soul Care Ministries International will work with students on a pay plan whereby a 50% deposit + N.C.C.A. Handling Fees and Shipping Costs are paid at enrollment and the balance is due prior to release of the student s grade for the course. I have read, fully comprehend, and accept SCM Institute s/ncca's policies and procedures. I understand that before I can receive my certification or license, my school account must be paid (up to date), and that all required documents have been successfully submitted. Full Name (Printed): Signature: Date: Return Enrollment Agreement, Questionnaire Responses and Check/Money Order to: Soul Care Ministries International, Inc. Attn: Dr. Linda H. King, Pres/CMO 3535 Peachtree Road, # Atlanta, GA Remit Credit Card Payments or Request Invoice via PayPal : Thank you, Dr. Linda H. King 5 of 5 P a g e

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