Apply Now for Mental Health Clinical Specialty Certification (MH-CSC)

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Payment

Application fee with a recurring annual fee of $100.00*

Price:

The annual $100 MH-CSC fee is in addition to your annual BCC payment.

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*** Once PAYMENT is complete -- return to this form to COMPLETE and SUBMIT at the bottom ***

Your Application will not be submitted until you click SUBMIT at the bottom of this form.

Upload a copy of Board-Certified Chaplain Certificate.

Board-Certified Chaplain Certificate

Max. file size: 50 MB.

Upload document showing minimally 400 hours of continuing education training in mental health issues.

Continuing Education Certificate

Max. file size: 50 MB.

Upload faith group endorsement letter.

Upload official letter of faith group endorsement below.

Faith Group Endorsement Letter

Max. file size: 50 MB.

Consent*

By typing my name on this line, I hereby certify the information on this application is true to the best of my knowledge. And I acknowledge that before this application is complete, I will have to submit my social security number upon request for a background check.

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