CCD of Texas Teacher Application Form
Completing this form is the first step in becoming a Chapter Teacher in the CCDOT Chemical Dependency Recovery Program. Please enter all data, attach both your written Christian Testimony and referral letter from your Pastor, and return them to the CCDOT office.
Name:
Address:
City, ST Zip:
Phone Number:
Email Address:
Employer:
Home Church:
Address:
Teaching Experience:
Counseling Experience:
Education:
Special Skills and Abilities:
Referred by:
Date Available to Start:
Applicant's Signature:
Today's Date:
Return to: CCD of Texas, Sachse, Texas