School of Psychology & Counseling

CPCE Exit Exam Registration Form

Exam Date: Sunday, August 7, 2016
Exam Time: 12:30 p.m. – 4:30 p.m.
Location: TBD

**REGISTRATION CLOSES ON THURSDAY, JUNE 30, 2016**

(ALL FIELDS ARE REQUIRED)

First Name:
Last Name:
Phone: ( ) -
Email Address:
Student ID #:
What is your major in the Master's Program?

Marriage, Couple & Family Counseling
What is your anticipated graduation date?
Have you completed the minimum of 30 hours of coursework required to take the exit exam? Yes No
Have you previously taken the exit exam? Yes No

Thank you for taking the time to fill out this form.  To submit your request to the School of Psychology & Counseling clicking "Submit" button below. You should receive a confirmation email upon clicking "Submit". If you do not receive one, contact the Field Placement Liaison, Karen Mercer, at karemer@regent.edu.

Regent University