Interest Form | heal.be.live.

THE W.I.T.C.H.
Participant Interest Form

View Requirements to Participate!

Watch A Video About THE W.I.T.C.H.!

If you would like to participate in THE W.I.T.C.H. Training Pilot Program, please complete the form below!

*Registration for the "Teaching for Social Justice" course closes Friday, January 20th, 2023.*

*Registration for the EMU NEXT Scholars closes Wednesday, February 1st, 2023.*

*Registration for Connect Detroit closes Friday, March 10th, 2023.*

First & Last Name

What school/college or university/organization/company are you CURRENTLY enrolled in or working for?

I confirm that I am... (please select ONE):

A graduate student in a program for: counseling, social work, psychology, sociology or another related field.

A graduate student in a program for educators working with K-12 students or for education leadership.

A professional working in a helping or education field for 1-3 years.

I confirm that I have at least ONE of the following interests (select all that apply):

I am interested in working with Black students and/or young Black clients.

I am interested in working in geographical areas/regions that are underresourced.

I am interested in working with populations that have experienced at least 2 or more traumatic life events.

This research study consists of six (6) hours of training. Participants will also be asked to participate in one (1) hour of assessments, including: one pre-assessment, one-post assessment and post-study debrief(s). Please check all that apply: *

I am willing to complete six (6) hours of training.

I am willing to volunteer to complete one (1) hour of assessments.

All participants that successfully complete the full research pilot study will be issued a certificate of participation!

Additional Comments:

THE W.I.T.C.H. Participant Interest Form

THE W.I.T.C.H.
Participant Interest Form