Please complete the form below to apply to the Couples Therapy Training Program. Any questions can be directed to Michael Wannon at menaw1@aol.com.
An application fee of $50 needs to accompany this application.  Complete the application on this page if you prefer to pay by check.   If you prefer to pay by credit card, please click here to go to the application page for credit card payments.

Application Form - Couples Therapy Training (Check)

  • Date Format: MM slash DD slash YYYY
  • Drop files here or
  • Please list your current insurance carrier.
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  • List the College/University you attended, your Major, # of Credits, Degree and Date of Graduation.
  • List the name of the Institution, Course/Programs, Dates and Supervisors.
  • List your training & professional experiences, listing most current first. Include Dates, Client Age Range, Treatment Modality, Setting (Hospital/Clinic), Hours per Week, and Supervision (Type, Individual, Peer, Group, etc., and Frequency).
  • e.g. research, teaching, community work, writing, etc.
  • List the type of psychotherapy (individual, family, couples, group), the therapist's name(s) and theoretical orientation(s), when, how often, and how long.
  • If you do not have adequate room in the designated spaces above, use this space to upload anything else you want to share.
    Drop files here or
  • Couples Application Fee

  • A $50 application fee is required with the submission of the training application. This fee is non refundable, but will be applied to your tuition. You have chosen to pay the application fee with a check. Please make the check payable to ICP+P and send to ICP+P, 4601 Connecticut Ave., NW, Suite 8, Washington, DC 20008.
    Price: $50.00
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