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CCC MEMBERSHIP & CERTIFICATION APPLICATION FORM

Canadian College of Christian Counsellors

Thank you for your interest in becoming an accredited member of the Canadian College of Christian Counsellors. This application is for individuals seeking professional certification as Christian counsellors. Please complete all applicable sections and include required documentation.

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
Do You Have Children?
Yes
No

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

Canadian Christian Counselling Clinic 
Canadian College of Christian Counsellors


300 Water Street Whitby Ontario, L1N 9B6


Tel: (416) 391-5000
Email:  

info@christiancounsellors.ca

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

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