Haverhill • Lawrence
Human Services Program
Information for Applicants for Fall and Spring
Alcohol Drug Abuse Counseling Certificate
Community Support Human Services Practitioner Certificate
Direct Support Certificate
Human Services Associate Degree
Your admission file will be reviewed on a rolling admissions basis after all of the required documents are
submitted and the criteria are met. Please read the Admission Requirements and Documentation carefully. It
is to your advantage to complete your application as early as possible.
Students may be admitted in either the fall or the spring semester. In the event the program is filled for that
semester, a waiting list will be generated. Students who are placed on the waiting list and who do not get
accepted into the program this semester, will be offered conditional acceptance for the following semester.
If you
do not meet the minimum requirements this semester and are not accepted into the Human Services Programs,
you will be admitted into General Studies: Human Services. In this general studies program you are able to
continue taking courses towards Human Services requirements to improve your chance to be accepted into the
programs the following semester.
Please review this additional and important information:
Transfer credits: Transfer credits for courses taken at other institution(s) are awarded only for comparable
courses which are completed with a grade of “C” or better.
Health requirements: Information regarding health requirements will be sent to you by Student Records,
upon acceptance.
Transportation: Students are responsible for their own transportation to a variety of facilities for
practicum.
Criminal Offender Record Information (CORI) and Sex Offender Record Information (SORI) checks:
Students interested in participation in an academic program that involves working with children, the disabled, or
the elderly, or a cooperative education experience or a program that includes a clinical affiliation with a private or
public health care provider, may be required to undergo a Criminal Offender Record Information (CORI) check, a
Criminal Records Central Repository (CHRI) check and/or a Sex Offender Registry Information (SORI) check.
Students will need to provide a government issued photo identification and sign a release form allowing the
college to view the student’s CORI, CHRI or SORI reports. Depending on the contents of a student’s CORI,
CHRI or SORI reports, participation in an academic program or a cooperative education experience or a clinical
or practicum affiliation related thereto, may be denied. CORI checks may be performed pursuant to Mass. General
Laws, Chapter 6, Section 172, and consistent with guidelines promulgated by the Executive Office for Health and
Human Services, and/or the Commonwealth’s Department of Public Health.
SORI checks may be performed
pursuant to Mass. General Laws, Chapter 6, and Sections 178(J) & 178(K). CHRI checks may be performed
pursuant to New Hampshire law. For more information, contact the Registrar at 978-556-3700. SORI checks are
not required to provide authorization for CORI/CHRI checks until they register for the practicum class.
Human Services Program
Information for Applicants for Fall and Spring
Alcohol Drug Abuse Counseling Certificate
Community Support Human Services Practitioner Certificate
Direct Support Certificate
Human Services Associate Degree
Admission Requirements & Documentation
All applicants must complete the following items to be considered for acceptance:
Applicant Checklist: Check off criteria upon completion.
Apply to NECC by completing an admissions application.
Submit an official high school transcript/diploma or GED scores/certificate.
Submit official sealed college transcripts to the Registrar from the colleges you have previously
attended, if applicable.
Take the Academic Skills Assessment in reading, writing and mathematics. Applicant’s need to
test out Reading and Writing. To take the assessments, please call the Assessment Center at (978) 556-
3428. It is possible to be waived from assessments if you have successfully completed specific college
course(s). Please submit official sealed college transcript(s) to the Registrar for evaluation.
Submit the completed Background Information Form (form attached) to: Brian MacKenna-Rice,
LMHC, LADC I, Coordinator for the Human Services Program, Northern Essex
Community College, 100 Elliott Street, Haverhill, MA 01830.
Attendance at a Human Services Program Information Session (see enclosed flyer for dates and sites) is
a required first step in the application process. At the Information Session you may talk with faculty and
set up an appointment for an interview.
Interviews will be scheduled with the Program Coordinator or the Program Staff Associate after the
applicant has attended the Program Information Session. Interview appointments will be scheduled at
the Information Sessions or you may contact Brian MacKenna-Rice, Human Services
Program Coordinator, at (978) 556-3331, to arrange an appointment after you have attended an
information session.
Human Services Programs
Background Information
The purpose of this form is to assist the Program Coordinator in planning an appropriate educational curriculum
for students in the program. Clinical practicum placement takes into account your present life circumstances,
work experiences, and future career plans.
Please return this form to: Brian MacKenna-Rice, LMHC, LADC I, Human Service Program Coordinator
Northern Essex Community College, 100 Elliott Street, Haverhill, MA 01830
Check one for the program for which you are applying
Alcohol/Drug Abuse Counseling Certificate
Community Support H. S. Practitioner Certificate
Direct Support Certificate
Human Services Associate Degree
Applicant Information (to be completed by the applicant):
Name: ________________________________________________________ Date: ________________
NECC ID (if known): ____________________________________________________________________
Address: __________________________________________________________________________
Street City
State Zip
Home phone: (_______) _____________________ Work phone :( _______) ______________________
Emergency phone: (________) _______________________ Date of Birth: _____________________
Email address: ____________________________________________________________________
Education:
High School: _____________________________________________ Date graduated: ____________
GED: ________________________________________________ Date of completion: ____________
College courses:
If you attended other colleges, please attach a copy of college transcript(s) or bring it to the interview with the
Program Coordinator. As an alternate, you may list below any courses you took in colleges regardless of whether
they were related to Human Services or not.
Work Experiences:
List all work experiences and dates of employment in the last five years regardless of whether this experience
was in the Human Services field. Begin with current employment. Include name of employer, dates of
employment and nature of employment.
Volunteer Work Experience:
List all volunteer work experiences, community or school activities.
Hobbies or Special Interests:
Additional Information:
Have you ever completed a CORI (Criminal Offender Record Information check) for a job, Human Service
training or volunteer license?
Yes No
Do you
have a valid driver’s license?
Yes No
Statement:
Write a brief statement as to why you have applied to this program and what you hope to gain from this
program.
Are ther
e any special life circumstances that need to be taken into consideration to plan an appropriate
curriculum for you in this program? If so, please explain below.
How did you hear about our Human Services Program?
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome