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Licensed Consultant Reinstatement Request
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Thank you for your interest in reinstating your Licensed Consultant status. Please complete the form below. Someone from the Standards for Excellence Institute will respond to your inquiry within the week.
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First Name
Last Name
Year of Licensed Consultant Training
I am interested in re-instating my Standards for Excellence Licensed Consultant status.
Yes
No
Phone
Email
Mailing Address Line 1
Mailing Address Line 2
City
State
Zip Code
Please submit one of the following
LinkedIn Profile
Resume
I understand that reinstatement into the Licensed Consultant program is not guaranteed. I understand reinstatement is contingent upon:
Re-acceptance into the Standards for Excellence Licensed Consultant program (which includes consultation with local Standards for Excellence replication partner where applicable)
My participation in a Standards for Excellence Pass to Excellence,Clinic Series or other similar series/course offered by the Standards for Excellence Institute or a licensed replication partner at my own expense, including fees, travel, etc.
Payment of $150 reinstatement fee, plus optional purchase of Standards for Excellence codebooks and other materials.Entering into a new Standards for Excellence Licensed Consultant agreement (including payment of applicable annual licensing fees moving forward)
Yes
No
Current Progress,
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