Department of Budget and Management

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.***

Do you currently possess a license as a Licensed Clinical Professional Counselor (LCPC) from the Maryland Board of Professional Counselors and Therapists?

If you answered NO to the above question, are you scheduled with the Board to be licensed within the next 6 months?

Describe your experience working with an adolescent population with mental health and/or substance abuse issues. Please include the name of your employer, the dates of employment, job duties and the number of hours worked per week. If you do not have this experience, type N/A.

Describe your experience assessing and providing therapy to population of adolescents with mental health or substance abuse disorders in the Juvenile Justice system. Please include employers name, dates of employment, job duties and hours worked per week. If you do not have this experience, type N/A.