Coursework Form - Mental Health Counselor Access this form via website at: cca.hawaii.gov/pvl Instructions for filing "Coursework Form": • Each applicant must complete at least 48 semester hours or 72 quarter hours of GRADUATE LEVEL coursework that shall include the following subjects areas, with a minimum of 3 graduate semester hours or 5 graduate quarter hours in each subject area listed below. • Each course must be on your transcript and can only be listed one time on the form. • Attach a catalog description and syllabus for each course listed on "Coursework Form". • In each subject area indicate credits in semester hours (S) or in quarter hours (Q). • FAILURE TO PROVIDE THE REQUESTED INFORMATION BELOW WILL DELAY THE PROCESSING OF YOUR APPLICATION. Name of Applicant: Social Security No.: a. Human growth and development. Institution Course Number Course Title Term Hours S or Q Total Hours: Institution Course Number Course Title Term Hours S or Q Total Hours: b. Social and cultural foundations. c. Counseling theories and applications. Institution Course Number Course Title Term Hours S or Q Total Hours: MHC-02 0818R (CONTINUED ON PAGE 2) d. Group theory and practice. Institution Course Number Course Title Term Hours S or Q Total Hours: e. Career and lifestyle development. Institution Course Number Course Title Term S or Q Total Hours: Hours Date of Birth: