My T-JTA training will be offered in conjunction with a:
Licensed Health Facility
University or College
Other Education Organization
Other (Please specify)
Name and Address of Organization specified above
If part of an educational course
Name of Course
Date of Course
Participants - My T-JTA trainees will fall into the following categories:
Marriage & Family Counselors
Ministerial Students (Specify-Field of Study)
Graduate Student (Specify-Field of Study)
Undergraduate Students (Specify-Field of Study)
Other, Please specify
When are you planning to conduct your first T-JTA training seminar or course? :
Approximate Number of Participants:
How many times a year do you plan to offer T-JTA Training?
Instructor Qualifications (check all that apply)
License, registration or certificate in a counseling-related field
Masters or higher degree in counseling-related field. Specify Degree:
Training, certification, or teaching experience in counseling-related field. Please specify
At least 2 years’ experience using the T-JTA
Bachelor’s degree in counseling-related field. Specify Degree:
Other (Please specify)
Have you or someone else at your organization/agency ever applied or been approved to provide T-JTA Authorized Instruction?
If yes, PPI Account Number
Date of Approval
Name of Approved Instructor
If denied, date of Denial/Reason
Describe your intended T-JTA training course subject matter(s).
1. Describe what topics will be covered in your training class or seminar:
2. Provide a course outline and explanation of your training process:
Please describe your experience with the T-JTA:
Number of years used:
Approximate number of administrations:
Please check the edition year of the T-JTA Test Manual you are using:
Do you have a T-JTA Handbook?
If yes, please select the edition year:
Please indicate the year of Norms you currently use:
I use T-JTA Online Scoring (Norms included)
Please indicate the ways you have scored the T-JTA (check all that apply):
Please indicate which T-JTA Reports you have used with T-JTA Online Scoring/Software(check all that apply):
Trait Suggestion Sheets
How will orders for T-JTA materials be paid?
Prepaid (Indicate method of payment)
Official Purchase Order (U.S. only)
On Consignment (U.S. only)
The sale and use of the T-JTA is restricted in accordance with standards established by the professional
counseling associations. In particular, a test user should have a general knowledge of measurement
principles and of the limitations of test interpretation. The T-JTA will be made available only to
those individuals who have obtained a relevant degree from or who are currently enrolled in a college or seminary.
I agree to accept for T-JTA training only those persons who meet the requirements for eligibility to purchase
and use the T-JTA as explained above and in the T-JTA Authorized Instructor Guidelines. I agree to have each trainee complete
an Application/Qualification Summary, immediately following the completion of training. I will submit a list of trainees with
name, address, and email address if Applications are completed online. Alternately, I will collect, co-sign, and return the
Application Forms to Psychological Publications, Inc. for approval. I will complete and return to PPI a Training Registry
at the time of course completion.