BC School of Art Therapy ~ APPLICATION FORM

   1941 Lee Avenue     Victoria, BC Canada V8R 4W9
   Phone: 250~598~6434     Fax: 250~598~6449
   Email: info@bcsat.com

   Date:

   I wish to apply for:

        ___Certificate Program   ___Diploma Program

   Name:
    (first, initial, last)

   Home address:
    (incl. postal code)

   Work address:
    (incl. postal code)

   Phone: Home:
    (incl. full area code)

   Phone: Work:
    (incl. full area code)

   Email Address:

   Birth date:
    (with month spelled out)

   Citizenship:

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   Colleges/universities attended (list in chronological order, giving
   name, location, degree, date completed, and major):

   I agree to abide by the stated terms and ethics of the BC School of
   Art Therapy if accepted into the School:

   Signature:

   Date:

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   ENCLOSURES

     1. Tell us in one page about yourself in the past, what you are
        presently involved in, and your goals.
     2. Tell us in one page how you learned of this program, and why you
        wish to enroll in it.
     3. Have three people send letters of recommendation directly to the
        School indicating your strengths and weaknesses. These should
        include: one academic reference from a faculty member who knows
        your undergraduate work; one professional reference from someone
        with whom you have recently worked; and one character reference
        from someone who knows you well.
     4. Submit official transcripts of your university studies.
     5. Submit 20 slides or color photographs representative of your
        artwork. If your artwork includes black and white photography
        this is also acceptable.
     6. Enclose a $100.00 (non~refundable) application fee with your
        application. International students enclose $150.00.
     7. Submit a Criminal Records Check from your local police. This is a
        requirement for practicum placement.
     8. Submit a resume.
     9. All students are required to have a personal interview prior to
        admission. Qualifying students will then be notified of their
        admission into the program. A deposit will be required along with
        a letter of acceptance from the student. This deposit will be
        credited toward the first semester's tuition fees.

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   CHECKLIST

     1. Application form enclosed? ___yes ___no
     2. $100.00 application fee enclosed? ___yes ___no
     3. One page about yourself enclosed (item 1 above)? ___yes ___no
     4. One page about your interest in art therapy enclosed (item 2
        above)? ___yes ___no
     5. Course work in psychology completed?
           o Abnormal Psychology ___yes ___no
           o Personality Theory ___yes ___no
           o Developmental Psychology ___yes ___no
           o Counselling Techniques ___yes ___no
           o Group Processes ___yes ___no
     6. Pre-requisites, or equivalents of these courses?
           o Drawing ~ 39 hours or more ___yes ___no
           o Painting ~ 78 hours or more ___yes ___no
           o Clay/Sculpture ~ 78 hours ___yes ___no
                + Official Transcript(s) enclosed?
                  ___yes ___will follow
                + 20 slides/color prints enclosed?
                  ___yes ___will follow
                + Letters of reference: list name, address with postal
                  code and phone number of each of your three referees:
                  1 (academic) _______________________________
                  2 (professional) _____________________________
                  3 (personal) ________________________________
                + Criminal Records Check enclosed? ___yes ___no
                + Resume enclosed?___yes ___no