Northern Essex
Community College

Human Services Program

Information for Applicants for Fall and Spring

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.
Complete FAFSA
Submit the completed Background Information Form (form attached) to: Lisa Fabbri, MA,
Coordinator for the Human Services Program, Northern Essex Community College,
100 Elliott Street, Haverhill, MA 01830 or SCAN and email to: lfabbri@necc.mass.edu
Attendance at a Human Services Program Information Session/ Interview. This is a required first step in the application process. Your major(s)in this program will be identified through this meeting. The student interested in Human Services should contact the Program Coordinator, Lisa Fabbri, to coordinate a meeting time.
Email Lisa Fabbri at lfabbri@necc.mass.edu
Northern Essex
Community College

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: Lisa Fabbri, MA, Human Service Program Coordinator Northern Essex Community College, 100 Elliott Street, Haverhill, MA 01830 or SCAN EMAIL: lfabbri@necc.mass.edu

Check one for the program for which you are applying

Alcohol/Drug Abuse Counseling Certificate
Senior Care Specialist Certificate
Children's Behavioral Health Certificate
Peer Recovery Specialist 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 there 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?