Directions: Please complete the following application as thoroughly as possible. Do not leave any questions blank. You are encouraged to seek assistance if you need help or have questions. Funds will be awarded based on the following criteria:

• A degree in counseling or a mental health counseling related degree that qualifies you to become licensed in the state of Tennessee as an LPC-MHSP or LMFT.

• Official Transcript (accredited programs only, CACREP or COAMFTE.

• Evidence of a temporary license for the state of TN (must include assigned temporary license number and copy of the official letter from the Board).

• Copy of signed and dated contract for supervision (contract must reflect the fee for hourly supervision; awards are made for current supervision only and will not be made retroactively).

• Letter of interest discussing your (a) personal/professional background (b) financial need (c) future professional goals and licensure specialty area (300 words)

• Resume

• Two letters of recommendation from fully licensed counseling professionals on letterhead

• Applicants must be a Tennessee resident and of Black or African-American descent.

• Demonstration of need

Incomplete applications will not be reviewed