Educational Psychology Psychology Program Program Area Application for the Admission to the Counseling Psychology Ph.D. Program Name _____ WSU ID: _____ Current ...

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  • Educational Psychology Program

    Program Area Application for the Admission to the Counseling Psychology Ph.D. Program

    Name _________________________________________ WSU ID: __________________ Current Address: ___________________________________________________________ Number-Street (Apt. #) City-State Zip Home Phone: ______________ Cell Phone: ______________Work Phone: _______________ E-mail: _________________________________________________________________ Current Occupation: ________________________________________________________ Education High School Location Last Grade check one ___ Diploma

    (City, State, Zip, Country) Completed ___ GED ________________ ____________________ _______ ________________ ____________________ _______ ________________ ____________________ _______ Vocational Location Last Grade Type of Course Certificate School(s) (City, State, Zip, Country) Completed or Major Granted ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________ Undergraduate Location Last Grade Type of Course Degree Universities/ (City, State, Zip, Country) Completed or Major Granted College(s) ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________

  • Professional/ Location Last Grade Type of Course Degree Graduate (City, State, Zip, Country) Completed or Major Granted Univ/College(s)

    ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________ ____________ ____________________ ________ __________ _________

    Other courses or workshops:

    To what clubs or organizations do you currently belong or did you belong in the past?

    Date Graduate Record Exam (GRE) Taken or Scheduled: _____________________

    Conviction/Revocation Information Yes No

    1. Have you ever been convicted of, pled no contest to, or pled guiltyto a felony? (check one) ___ ___

    2. Have you ever been convicted of, pled no contest to, or pled guiltyto a misdemeanor involving a minor? (check one) ___ ___

    3. Have you had a psychologist, teaching or administrator certificateSuspended or revoked? (check one) ___ ___

    Foreign Languages

    Please list all in which you are fluent:

    Work Experience

    List your present or most recent job first:

    1. Name of Employer: ______________________________________________________Location: _____________________________________________________________From: __________ To: ___________Reason for leaving? ______________________________________________________Description of Job:

  • 2. Name of Employer: ______________________________________________________ Location: _____________________________________________________________ From: __________ To: ___________ Reason for leaving? ______________________________________________________ Description of Job:

    3. Name of Employer: ______________________________________________________ Location: _____________________________________________________________ From: __________ To: ___________ Reason for leaving? ______________________________________________________ Description of Job

    Which of the above jobs did you like best? Why? Interests What do you do in your spare time? (hobbies, sports, music, etc.) Which do you like most? If you had the time and money, what other things would you like to do in your spare time? What books and articles have you read recently?

  • What newspapers and magazines do you read most frequently? In what subjects are you especially interested? By submitting this application, you are certifying that you are capable of meeting all of the essential requirements of this program and function in the full role of the counseling psychologist. Please sign and date to indicate understanding. ______________________________________________ _______________________ Signature Date

  • Personal Essay Instructions: Develop an essay that incorporates your response to both of the following questions: 1) There are many types of psychology. Why do you wish to become a Counseling Psychologist? Spend

    time specifically talking about this type of psychology. Also, 2) there are other counseling psychology programs out therewhy do you want to be considered for our Counseling Psychology Doctoral Program? Tell us about your professional/career goals in detail and how our program will help you achieve them. 3) Also discuss your research interests and which faculty members with whom you might wish to work. (Please begin response here or attach a separate page)

    Counseling Psychology PhD Program: undefined: WSU ID: Cell Phone: Work Phone: undefined_2: Home Phone: Current Occupation: 1: 2: 3: City State Zip Country 1: City State Zip Country 2: City State Zip Country 3: Completed 1: Completed 2: Completed 3: Schools 1: Schools 2: Schools 3: City State Zip Country 1_2: City State Zip Country 2_2: City State Zip Country 3_2: Completed 1_2: Completed 2_2: Completed 3_2: or Major 1: or Major 2: or Major 3: Granted 1: Granted 2: Granted 3: Colleges 1: Colleges 2: Colleges 3: Colleges 4: 1_2: 2_2: 3_2: 4: 1_3: 2_3: 3_3: 4_2: 1_4: 2_4: 3_4: 4_3: 1_5: 2_5: 3_5: 4_4: UnivColleges 1: UnivColleges 2: UnivColleges 3: UnivColleges 4: 1_6: 2_6: 3_6: 4_5: 1_7: 2_7: 3_7: 4_6: 1_8: 2_8: 3_8: 4_7: 1_9: 2_9: 3_9: 4_8: Date Graduate Record Exam GRE Taken or Scheduled: List your present or most recent job first: Name of Employer: Location: undefined_3: To: Name of Employer_2: Location_2: From: To_2: Reason for leaving: Name of Employer_3: Location_3: From_2: To_3: Reason for leaving_2: Date: Check Box2: Check Box3: Check Box4: Check Box5: Check Box6: Check Box7: Check Box8: Check Box9: Text10: \Text11: Text12: Text13: Text14: Text15: Text16: Text17: Text18: Text19: Text20: Text21: Text22: Text23: Personal Essay:

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