THE GOLDEN CERTIFICATION TRAINING COURSE REGISTRATION
*Required Field
Educational Background
*Do you have a Masters Degree or PhD/EdD in Psychology, Sociology, Human Services, or Nursing?
Yes
No
*Highest degree attained:
*Name of Institution where highest degree attained:
*Major, or program of study:
*Year degree was completed:
*Have you attended any of these certification training programs?
If you answered 'Other' above, specify who you were certified by; otherwise leave blank:
If you have a certification, please tell us when you received your certification:
(date)
*Do you hold a certification by, or full active membership in, any of these professional organizations?
*List the title, date, and organization of any applicable training and/or courses you have completed in the use of psychological tests.
*Professional experience using Psychological Tests
*List professional licenses/certificates you presently hold; please provide license description, license number, issuer, where
valid, and expiration date. Or identify your qualified sponsoring mentor's or organization's name, address, phone number and
e-mail address.
Login and Password:
If you presently hold a GoldenLLC administration account, please check this box: and then enter your Golden LLC Login and Password below:
Desired Login ID
(6 to 8 characters)
*Desired Password
(use letters and numbers)
