CRCC Emerging Leaders Network Interest Survey Question Title * 1. What is your name? Question Title * 2. Please provide your preferred email address (if you are student, please provide a non-school email address). Question Title * 3. Are you a CRC? If yes, please provide your CRC customer ID number. Yes No CRC customer ID number Question Title * 4. Where are you located? Question Title * 5. Are you currently a graduate student? Yes No Question Title * 6. What is your master's degree in? Rehabilitation Counseling Clinical Rehabilitation Counseling Additions/Substance Abuse Counseling School/Guidance Counseling Mental Health Counseling Counseling Psychology Marriage and Family Counseling/Therapy Social Work Other (please specify) Question Title * 7. Where did you earn your master's degree? Question Title * 8. When did you graduate from your master's program (or anticipated graduation date)? Graduation date (or anticipated graduation date) Date Question Title * 9. What is your undergraduate degree in? Question Title * 10. Where did you earn your undergraduate degree? Question Title * 11. What is your current practice setting? Select all that apply. Student Education Health Sector Community Rehabilitation Programs VHA/VBA State VR Government Agency Private Practice Forensics Social Security Lifecare Planning Other (please specify) Question Title * 12. What areas in the rehabilitation counseling profession would you like to discuss within the Emerging Leaders Network (i.e. challenges, strengths, etc.) Question Title * 13. What topics of advocacy are you interested in? Select all that apply. Legislation Public awareness Disability equity Employment accommodations Licensure DEI Other (please specify) Question Title * 14. What topics would you like to explore within the Emerging Leaders Network? Select all that apply. Work settings Assessments/Resources for clients Continuing education & training Mentorship Networking events Scopes of practice within the Rehabilitation Counseling field Other (please specify) Question Title * 15. Are you interested in a leadership role within the Emerging Leaders Network? Yes No Done