South Lake Tahoe
Certification Registration Form

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Phone*[ (000)123-1234 ]   Fax

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Permission for GS Consultants to publish my information on the program roster:

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Note: Program materials are purchased directly from CPP, Inc.

• Strong Interest Inventory® Manual and User’s Guide Set — Product #8400

Please answer the following:

What is your highest level of education? High School Bachelor's Degree Master's Degree Doctorate Other

Field of Study?

Have you been previously approved by CPP to purchase restricted psychological assessments?
Yes   No

How do you rate your knowledge of the Strong Interest Inventory® ?
None   Some   Expert

Please check if you are taking this program for continuing education units:

(CEUs are $25 per program)  NBCC Other

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