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CCC MEMBERSHIP & RENEWAL APPLICATION FORM

Canadian College of Christian Counsellors

Is this your first application or a renewal?
Regular Application
Renewal Application

Personal Information

Please provide your legal name, as it should appear on your certificate.

Home Address

Your current residential mailing address.

Multi-line address
Birthday
Year
Month
Day
Gender
Male
Female
Marital Status
Single
Married
Divorced
Separated
Widowed

Contact Information:

Canadian Christian Counselling Clinic 
Canadian College of Christian Counsellors


300 Water Street Whitby Ontario, L1N 9B6


Tel: (416) 391-5000
Email:  info@christiancounsellors.ca

Hours

Mon-Fri 9:00 am - 5:00 pm
Saturday 9:00 am - 2:00 pm
Sunday 9:00 am - 2:00 pm

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CONTACT US

Canadian Christian Counselling Clinic 
Canadian College of Christian Counsellors


300 Water Street Whitby Ontario, L1N 9B6


Tel: (416) 391-5000
Email: rbrooker@canadachristiancollege.com

Mon-Fri 10:00 am - 6:00 pm

Copyright © 2025 by Canadian College of Christian Counsellors and Canada Christian College

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