One Year Training Program Application
Name_____________________________________ D.O.B.___________
Home Address_______________________________________________
___________________________________________________________
Business Address_____________________________________________
___________________________________________________________
Home Phone (with area code):___________________________________
Business Phone (with area code):_________________________________
How did you learn of our program?: _______________________________
PLEASE SUBMIT:
1. An autobiographical essay, 3 to 5 pages, including personal background and the
reasons, personal and professional, you became a therapist. As part of the essay,
please address your strengths as well as the dilemmas you encounter or anticipate
encountering in your work. Please include a brief description of your own experience
in psychotherapy or psychoanalysis including dates and orientation of treatment.
Also, include your experience in group learning environments and anything you think
is relevant for us to know about your participation.
2. A current resume including work experience, setting and dates of employment,
educational experience including college, graduate and post-graduate training as well
as state licenses.
3. Transcripts for graduate and post-graduate training.
4. Two letters of reference, one personal and one professional.
5. All materials should be sent to the WTCI with a $50.00 non-refundable application fee.
APPLICATION CRITERIA:
We will consider applicants with a graduate degree in the mental health professions
with a current caseload or clinical practice. Highly motivated nontraditional applicants
in related fields may be considered. If a member of the WTCI is or ever was your therapist, she will not review your application. We do not discriminate on the basis of race, class, sexual preference or physical disabilities.
Application is due by June 15, 2010.
