CMPC Program Application Form

Synergistic Solutions CMPC Mentee Application Form

**The application period for our current CMPC group cohort is now closed. We will be opening it back up later this year (2026) If interested in pursuing 1:1 mentorship with us at this time, feel free to complete this application form. **

Eligibility for designation as a Certified Mental Performance Consultant (CMPC) requires a significant amount of dedication, diligence and intentionality in pursuing knowledge, skills, and abilities that indicate core competencies in serving performers across multiple performance domains. By completing this application, you are indicating a desire for Dr. Angel Brutus, LPCC, ACS, BC_TMH, CMPC/Synergistic Solutions to consider entering into a formal mentor-mentee relationship with intent on your willingness to complete requirements for the CMPC designation. Note: This is NOT an application for clinical supervision.

First name

Last name

Phone

Address (Street Number, City, State, Zip Code)

Which best describes your current education level?

Current Master's Student in a Sport Psychology Training Program

Current Doctoral Student in a Sport Psychology Training Program

Non-Degree Seeking Professional Currently Taking Supplemental Coursework to Complete CMPC Requirement

Other

Have you entered into an agreement with a CMPC mentor in the past?

Yes

Maybe

Please mark all completed coursework at the time of this application.

Do you currently have a contract or relationship with an organization that has agreed to allow opportunity for you to provide direct sport, exercise, and performance psychology-related services?

Yes

Maybe

When do you anticipate being able to complete all of the required mentorship hours toward CMPC certification?

In the next 4 months

In the next 8 months

In the next 12 months

In the next 18 months

Are you or your organization planning to pay for this offering?

I plan to pay for it myself.

I plan to pay for it myself, through my professional development budget at work.

My organization/workplace plans to pay for it directly on my behalf.

Other

Submit your cover letter

Upload your file

Choose a file or drag and drop one here.

Submit your CV/Resume

Upload your file

Choose a file or drag and drop one here.

Provide the Name, Email Address, and Phone Number of 3 Professional References

By completing this preliminary application, you acknowledge this does not indicate an agreement for a formal mentor-mentee relationship until a contract has been signed by both parties. Please sign your name indicating understanding.

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Synergistic Solutions CMPC Mentee Application Form

Address (Street Number, City, State, Zip Code)

Which best describes your current education level?

Current Master's Student in a Sport Psychology Training Program

Current Doctoral Student in a Sport Psychology Training Program

Non-Degree Seeking Professional Currently Taking Supplemental Coursework to Complete CMPC Requirement

Other

Have you entered into an agreement with a CMPC mentor in the past?

Yes

Maybe

Please mark all completed coursework at the time of this application.

Do you currently have a contract or relationship with an organization that has agreed to allow opportunity for you to provide direct sport, exercise, and performance psychology-related services?

Yes

Maybe

When do you anticipate being able to complete all of the required mentorship hours toward CMPC certification?

In the next 4 months

In the next 8 months

In the next 12 months

In the next 18 months

Are you or your organization planning to pay for this offering?

I plan to pay for it myself.

I plan to pay for it myself, through my professional development budget at work.

My organization/workplace plans to pay for it directly on my behalf.

Other

Submit your cover letter

Upload your file

Choose a file or drag and drop one here.

Submit your CV/Resume

Upload your file

Choose a file or drag and drop one here.

Provide the Name, Email Address, and Phone Number of 3 Professional References

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.