Apply to ICDS

Which Chemical Studies option are you looking to take?
Classroom Learning for Chemical Studies Distance Learning for Chemical Studies

Salutation
Mr. Ms. Mrs. Dr. Prof.

First Name *

Last Name *

Email: Please use a valid email addressA value is required.Thank you!*

Phone: A value is required.Please use (000) 000-0000 format*

Mobile: Please use (000) 000-0000 format

Birthday:A value is required.Please use mm/dd/yyyy format*

Address:*

City:*

State:*
AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip:*

SSN:Please use 000-00-0000 format

Contact me by:
Phone Email Either

Best Time to be Reached:
Mornings Afternoons Evenings

My Interest Level:
Very High - I'm ready to begin immediately High - I'm excited Medium - I have more questions Low - I'm just gathering information

My Education Level:
Less than High School/GED High School/GED Some College Associate's Degree Bachelor's Degree Master's Degree or Higher

Financing Plan:
I'm applying for a student loan I'm seeking outside funding Payment plan with ICDS Military Spouse funding I'm paying in full Not sure/other

Why are you interested in becoming a drug & alcohol counselor?

Other Education:

How did you find out about ICDS? Advertisement Employee Referral External Referral Conference Web Word of mouth Other