A Christian Liberal Arts University, Est. 1846

Mild Intervention Licensure Application

Welcome to the official application for admission to the Mild Intervention Licensure program.

Please complete each field and click "submit". Items marked with an asterisk are required. If the web browser is closed prior to submission, the information entered will be lost. It will take approximately 30 minutes to complete the application.

Please note that this application is only one part of the overall process. If you have any questions, please contact the office by calling 800-845-3149 or email online@taylor.edu.

You must fill out ALL REQUIRED FIELDS to submit your enrollment successfully.

Please fill out all required(*) fields correctly

Personal Information

Contact Information

Demographic Information



  American Indian or Alaskan Native
  Black or African American
  Native Hawaiian or other Pacific Islander
Prior Education/Licensure Information

  Pursuing mild intervention licensure
  Coursework for license renewal



Upon candidate completion of above conditions, the candidate will be eligible for admission to the Mild Intervention Licensure Program as a guest student at Taylor University. By entering my name, I understand and will comply with the requirements to be admitted to the Mild Intervention Licensure Program at Taylor University. I certify that the information provided is accurate and complete.

This application is only one piece of the material required for applying to the Mild Intervention Licensure Program. Please go to the "Admissions" page for more information.