Clinical Residency Application

Residency Applicant Submission Form

Thank you for your interest in a position with Optimum Joy Clinical Counseling!
Contact Information

Please fill in your information and upload the requested documents for consideration:
First Name*
Last Name*
Email Address*
Phone Number*
Please enter a valid phone number.
Were you referred for clinical residency by a member of Optimum Joy's staff?*
We love seeing that! Please let us know who referred you to apply with our office:
Desired Position*
If the position you seek is not listed, please select the closest match
What school are you enrolled at? *
What days do you prefer to do in person appointments at the Chicago Office?*

MondaysTuesdaysWednesdaysThursdays (required evening and in office day)FridaysSaturdaysSundays
Can you commit 2 evenings each week?*

YesNo
Which dates align with your graduate school schedule for doing practicum, internship 1, and internship 2 with our office? *
Our office provides an academic scholarship for those in need of the financial support. If you were to receive a scholarship, can you describe your need for the scholarship and how you will use the funds during the academic year? *
Are you currently or have you ever in the past been a client of Optimum Joy Clinical Counseling?*

NoYes
Please provide your resume, cover letter and the contact information of two references, of which one may be a personal reference.
References
Cover Letter*

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Resume*

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Optional Additional File

You may optionally add an additional file such as a copy of a license, a photo, or any relevant pdf you'd like to opt-in and provide
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Residency Applicant Submission Form

Contact Information