Sexual Addiction Recovery Coaching Application

Certified Sexual Addiction Recovery Coach (CSARC)

The Board of Christian Coaching (BCC) is affiliated with World’s largest and most diverse faith-based mental health organization, the American Association of Christian Counselors, and is open to all mental health professionals, coaches, pastors, chaplains, para-professionals, and lay counseling ministry leaders who identify themselves as Christian counselors. Our mission is to serve Christian counselors and coaches throughout the world in taking positive and tangible steps to develop the emerging professions of Christian counseling and coaching. Our vision is to create and maintain a viable and comprehensive Christian Care Network as a resource for hurting people.

Step 1 of 3

This form is intended for first-time applicants for the International Board of Christian Care’s Certified Sexual Addiction Recovery Coach credential.

Demographic Information

The following information is collected for application purposes only and will remain confidential. It will not be shared with third parties or used for any purpose outside of processing your application.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

The information provided above is used solely for application purposes, including sending correspondence and the physical copy of your credential. This information will not be shared with third parties. Please ensure this address is accurate and up-to-date to avoid delays in receiving your credential.

Please provide the name of your coaching business or the practice where you provide services

Example: Abundant Life Coaching

Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If your business address differs from your mailing address, please provide the details below. This information is used solely for application purposes and will not be shared with third parties. Please ensure this address is accurate, as it may be used for professional correspondence or records.

Work Phone

Cell Phone(Required)

Email(Required)

Enter Email Confirm Email

Please provide the email address associated with your TalentLMS account that you used when registering for Light University’s Sexual Addiction Recovery Coaching 101 and 201 courses. Using a different email address may result in delays in processing your application.

Gender(Required)

Male

Female

Age(Required)

Ethnicity(Required)

Sexual Addiction Recovery Coaching Application

Certified Sexual Addiction Recovery Coach (CSARC)

This form is intended for first-time applicants for the International Board of Christian Care’s Certified Sexual Addiction Recovery Coach credential.

Demographic Information

Credential Designation

Professional/Formal Education and Training

Practice Information

Attestation

Attestation of Criminal History

Preferred Name with Credentials

CSARC Credential Certificate Name & Credentials