Drug and Alcohol Studies
CITY COLLEGE OF SAN FRANCISCO
HEALTH EDUCATION DEPARTMENT
Would You Like to Become Certified as a
Drug & Alcohol Counselor?
Apply now to enter the Fall 2015
Drug & Alcohol Studies Cohort!
** DEADLINE: MAY 15, 2015 **
Sponsored by the San Francisco Department of Public Health –
Community Behavioral Health Services (CBHS)
The State of California requires drug and alcohol counselors to obtain certification by a Stateapproved certifying organization. The Drug & Alcohol Studies Program at City College is certified
by the California Association for Alcohol/Drug Educators (CAADE) to provide the education
necessary towards certification. This year, we are welcoming 30 students to join the Cohort of
the CCSF Drug & Alcohol Certificate Program starting Fall 2015. As part of the Cohort,
students will be provided a FREE BOOK LOAN for two semesters and a STIPEND upon
completion of the 2nd semester.
Students will attend school once a week with the following schedule: Fall 2015: Mondays from
5-8pm (August 17 to September 28) and Spring 2016: 4-9pm from January to May. At the end of
the Spring 2016 semester, students will have taken the first 3 classes necessary for the Certificate.
The Cohort is only open to students who have never taken any Drug & Alcohol Studies
classes. If you have already taken HLTH 100, you cannot apply for this scholarship.
To apply for participation in the Cohort, please fill out the attached application.
The deadline for submitting applications is Friday, May 15, 2015 at 5pm. Notification of
acceptance will be given by May 20. The Cohort will begin with a mandatory orientation on
Monday, August 10. If you have any questions or would like more information, please contact
Craig Wenzl at (415) 452-5159 or cwenzl@ccsf.edu.
This Cohort book loan and stipend are funded in part by the San Francisco Department of Public
Health – Community Behavioral Health Services (CBHS). CBHS has been helping students obtain
their alcohol and drug certification since 1998 by providing professional development opportunities
in collaboration with the Drug & Alcohol Studies Program at CCSF.
CITY COLLEGE OF SAN FRANCISCO  HEALTH EDUCATION DEPARTMENT
 50 PHELAN AVENUE, MU353  SAN FRANCISCO, CA 94112
TANDY ILES, DIRECTOR - TEL: (415) 452-5160  FAX: (415) 452-5162 EMAIL: tiles@ccsf.edu
CRAIG WENZL, ASSOCIATE DIRECTOR - TEL: (415) 452-5159  FAX: (415) 452-5162  EMAIL: cwenzl@ccsf.edu
www.ccsf.edu/das
*** DEADLINE: MAY 15, 2015 ***
City College of San Francisco - Drug and Alcohol Certificate Program
CBHS Cohort & Free Book Loan
Fall 2015 Application (Page 1 of 2)
Please complete both pages of this application. If you have any questions, please contact
Craig Wenzl at (415) 452-5159 or CWENZL@ccsf.edu.
Name:
Address:
Phone #:
Email:
Agreements:




I will attend the mandatory orientation 5-8pm on Monday, August 10 at the CCSF
Ocean Campus at 50 Phelan Avenue, San Francisco.
I will be able to attend the weekly classes: Fall 2015: Mondays from 5-8pm
(August 17 to September 28) and Spring 2016: 4-9pm from January to May.
I have not previously attended a drug and alcohol studies program and have
not already taken HLTH 100 at City College.
(For students in recovery): I have a minimum of two years of recovery time.
Where did you hear about the Drug & Alcohol Studies Program?
________________________
.
*** Are you currently working at a CBHS-funded agency? (Yes/No/Don’t Know) _
(Priority is given to employees of CBHS or CBHS-funded agencies, although everyone is welcome
to apply.)
If yes, what is the agency?
Name of supervisor:
*** Have you ever taken any classes at CCSF? _________
If YES, when was the last semester? _________________
Applicant’s Signature:
Date:
*** DEADLINE: MAY 15, 2015 ***
City College of San Francisco - Drug and Alcohol Certificate Program
CBHS Cohort & Free Book Loan
Fall 2015 Application (Page 2 of 2)
PERSONAL STATEMENT OF INTEREST:
Please tell us about you! Introduce yourself and tell us about your interest in our
program. If you have faced unusual challenges or hardships, please describe them
and how you have responded. Let us know what would make you a great candidate
for participation in our program. This is your chance to tell us about you! (Please
attach additional pages as necessary).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Completed applications may be submitted in any of the following ways:




Hand-deliver to Craig Wenzl, Multi-Use Building (MUB) room 353 (please clearly
mark “Craig Wenzl” on the envelope) or
Fax to 415-452-5162 (attn: Craig Wenzl) or
Mail to Craig Wenzl, CCSF, 50 Phelan Ave. Box MU353, San Francisco, CA 94112
(postmarked by May 13) or
Email to CWENZL@ccsf.edu