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1 1 of 18 2/14/ :44 AM ATHABASCA UNIVERSITY. CANADA'S OPEN UNIVERSITY. Welcome, You have 1 incomplete application. Please click on the one that you want to edit. Then open the "Welcome" message for detailed instructions on how to proceed. Post-Masters Certificate in Counselling (PMC) WELCOME open all sections close all sections This application form is intended for students wishing to apply to the Post-Masters Certificate in Counselling program. If you are enrolled in a graduate program at another institution, you may not be enrolled in this program at the same time. Prior to completing the Post-Masters Certificate in Counselling program application, please ensure that you have carefully reviewed the detailed program information and application instructions on the GCAP Web Site. There are two main components to the Graduate Program Application. 1. Online Application Form The various components of the online application form appear in the sections on this page and on the left menu bar. You must complete all sections of the online application. Each time you enter new information into a section, be sure to click on the "Save" button to ensure that your data is not lost when you move on to the next section. You will then be able to log in and work on your application package at any time prior to the application deadline. Applications for admission must be submitted electronically, using the online forms provided. Applications will not be accepted by mail or fax. Only transcripts, reference letters and transcript evaluations from accredited organizations will be accepted by mail. See the information below about how to finalize your online application once all sections have been completed. 2. Hardcopy Application Materials Package You are also required to assemble a package of hardcopy materials for submission prior to the application deadline. You will enter certain information about the contents of this package in the online application form. It is then your responsibility to gather and assemble all of these items and submit them together in one package. Please submit these materials according to information on the GCAP Web site. These materials must be submitted by mail or courier. Do not fax or these materials. Checklist and Application Submission You are also provided with a checklist and application submission menu item. Its purpose is to enable you to track the various components of your application to ensure that all sections of the online application are complete and that your complete hardcopy application materials have been received. You can click on the links on the status sheet to enter your data into the components of the application that are showing as incomplete. Once you finalize a section of the online application, it will show as complete on the status sheet. Submitting Your Application for Final Review If you want to make further changes after finalizing a section, you have the option to "Unfinalize all sections" on the Checklist and Application Submission section. Remember you must then either finalize each section again or select "Finalize all sections" once you have made the changes. IMPORTANT: Finalizing all elements of the application does not mean you have applied to the program. When you have completed the entire application process, you must click on the "Proceed to Final Review" button on the Application Checklist. Make sure you do not select this button until you are satisfied that your application is in its final form. Once you select the "Final Review" button you will no longer be able to view or make changes to your application. You will be able to access the Application Checklist / Status Sheet to track the progress of your application through the admissions review process. Application Deadline It is your responsibility to ensure that all components of the application are submitted on time. You must complete all sections of the online form and ensure that your assembled Hardcopy Application Materials Package (official transcripts, letters of reference, and IQAS, ESL, and advanced credit assessments - if applicable) are received at the Graduate Centre for

2 2 of 18 2/14/ :44 AM Applied Psychology by the appropriate deadline below. October 1 for Winter semester February 1 for Spring-summer semester June 1 for Fall semester If you have difficulties accessing or submitting online forms, please review the instructions on each form carefully and then contact our technical support, using the "Help" button at the top of this page. For more information, contact the Application Advisor at (toll free in rth America) or send an to Inquiries should be limited to application content and procedures. Please do not call to verify receipt of application materials. Your application status sheet will be updated within 2 business days. It is your responsibility to allow enough time for materials to arrive in advance of the application deadline. If you are concerned about the safety and confidentiality of the personal information you submit, please read our Privacy and Security Policy. DEMOGRAPHIC INFORMATION your demographic information is complete. AU Student ID: First Name: Last Name: Middle Name: Preferred First Name: Gender: Date of Birth: Current Address: City/Town: Prov/State: Postal/Zip: Country: Contact Information Address: Primary Phone: * Your demographic information above is currently not available. If any of the information above is incorrect please login to the Office of the Registrar and click on the "View/Modify Personal Info" link in the left hand menu. At the time of registration, I will be A Canadian citizen A Permanent Resident / Landed Immigrant An international student residing in Canada A citizen of another country residing outside of Canada If not a citizen of Canada, please indicate your country of citizenship Do you have a physical, mental, psychological, or learning disability or other limitation for which you may require support to ensure your success as a student? (optional) If yes, please specify:

3 3 of 18 2/14/ :44 AM TRANSCRIPTS Please review the information on Transcripts prior to completing this section. Scroll down the page for transcript information. te: Please list all of the transcripts you are submitting here. You must submit transcripts from all post-secondary institutions you have attended. You must submit new Transcripts with each application to the program. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application. your transcript information is complete. 1. Enter the names of all post-secondary institutions from which transcripts have been requested, including Athabasca University (if applicable). INSTITUTION DEGREE ACQUIRED? Transcript 1: Transcript 2: Transcript 3: Transcript 4: Transcript 5: Transcript 6: Transcript 7: 2. If for any reason you are unable to provide official transcripts from one or more colleges or universities, please provide a detailed explanation below. For Students with Credentials from Post-Secondary Institutions Outside of rth America. Where applicable, the following official documentation must be received before your application can be processed. You may contact International Qualifications Assurance Services (IQAS) if you require a Basic Assessment. International Qualifications Assurance Services 9th Floor, 108 Street Building

4 4 of 18 2/14/ :44 AM Street Edmonton AB T5K 2J5 Canada IQAS website Other evaluation services are listed at: 3. I have requested an evaluation of my international transcripts from an accredited assessment agency and am submitting this assessment to the department with my hardcopy application materials package. INSTITUTION NAME DATE REQUESTED (DD/MM CREDENTIAL NUMBER 4. I have completed an English as a Second Language (ESL) assessment and am submitting this with my hardcopy application materials package. ESL ASSESSMENT SCORE LETTERS OF REFERENCE Please review the information on Letters of Reference prior to completing this section. te: All reference must be submitted using the GCAP Letter of Reference form. te: You must list all of your referees here. You must submit new Letters of Reference with each application to the program. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application. your list of referees is complete. Each applicant is required to provide three official letters of reference. The references must be completed using the GCAP Letter of Reference form. If you have previously applied to one of our programs, you will need to submit current letters of reference with each new application. your list of referees is complete. 1. Enter the address and relationship of the three individuals who will submit the online Letter of Reference form. Do not complete this step until you have confirmed with your referees that they are willing to submit letters on your behalf. te: Please provide a valid work address for each referee and where possible, do NOT enter a hotmail or yahoo address as GCAP often experiences transmission difficulties with these accounts. 2. After entering the address and relationship of three referees, click SAVE, then be certain to click LINK to Referee for each of the three. te: Once you have completed steps 1 and 2 above, you will NOT be able to make changes to this form. If you have made an error in this form and require changes to text after you have saved it, contact for assistance. te: You may track receipt of completed online references within Checklist and Application Submission, section B: Application Materials Tracking. REFEREE (ONE) RELATIONSHIP ACTION Reference 1: Relationship 1: Reference 2: Relationship 2:

5 5 of 18 2/14/ :44 AM Reference 3: Relationship 3: 2. If you are unable to find a referee with knowledge of your academic skills, please state the reason. ACADEMIC HISTORY Please review the information on Entrance Requirements prior to completing this section. te: You must complete all components of your academic history. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application (e.g., you have not taken any additional courses outside of your degree). your academic history is complete. 1. Are you currently enrolled in another university program? If yes, please specify: University Program Anticipated Completion Date (DD/MM 2. Are you currently a n-program Student in another Athabasca University graduate program? If yes, please specify: University Program Anticipated Completion Date (DD/MM 3. Have you previously been enrolled in or completed any courses or programs within GCAP? If yes, please specify: Program Anticipated Completion Date (DD/MM 4. List in order, beginning with the most recent, all completed degree work: Institution Program of Study and Dates Credential Awarded and Date

6 6 of 18 2/14/ :44 AM Degree: Major/Double Major: (DD/MM (DD/MM Degree: Major/Double Major: (DD/MM (DD/MM Degree: Major/Double Major: (DD/MM (DD/MM Degree: Major/Double Major: (DD/MM (DD/MM Degree: Major/Double Major: (DD/MM (DD/MM Degree: Major/Double Major: (DD/MM (DD/MM Degree: Major/Double Major: (DD/MM (DD/MM Degree: Major/Double Major: (DD/MM (DD/MM: (DD/MM: (DD/MM: (DD/MM: (DD/MM: (DD/MM: (DD/MM: (DD/MM:

7 7 of 18 2/14/ :44 AM (DD/MM 5. Next, list any additional post-secondary education, including degrees in progress or additional coursework. List in order, beginning with the most recent. Please include any non-program studies at Athabasca University. Please include any non-program studies at Athabasca University. Institution Program of Study and Dates Anticipated Completetion Date Credential if applicable Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM

8 8 of 18 2/14/ :44 AM Degree/Credential: Major/Double Major: (DD/MM (DD/MM: (DD/MM 6. Please indicate the nature of your baccalaureate degree 4 year degree (120 credits) 3 year degree (90 credits) ADVANCE CREDIT ASSESSMENT Please review the information on Advance Credit Assessment prior to completing this section. te: You must complete this section even if you are not applying for transfer credit. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application (e.g., you have not taken any graduate level courses). your transfer credit information is complete. 1. Have you taken graduate level courses before? If yes, please supply the following information. Be sure to indicate if you are applying for advance credit for any courses not already credited towards one of the credentials listed in the academic history section. INSTITUTION COURSE NUMBER COURSE TITLE FINAL GRADE DATE COMPLETED (DD/MM ADVANCE CREDIT REQUESTED

9 9 of 18 2/14/ :44 AM For applicants applying for advance credit only: 2. Please confirm that you will be including the advanced credit assessment application and fee with your hard copy application materials package. PROGRAM PREREQUISITES Please review the information on Program Prerequisites prior to completing this section. te: You must provide complete information about your course prerequisites. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application. your program prerequisite information is complete. 1. Please indicate your intended area of specialization Counselling Psychology Career Counselling Art Therapy 2. Please complete the table below to indicate Approved Prerequisites. These courses must appear on your official transcripts. APPROVED PREREQUISITES DEVELOPMENTAL PSYCHOLOGY: LEARNING PSYCHOLOGY: COUNSELLING THEORIES/ PERSONAITY THEORIES: ABNORMAL PSYCHOLOGY: REQUIRED ONLY FOR ART THERAPY STREAM t Available... t Available... t Available... t Available If you do not have an Approved Prerequisite in one or more areas, please complete the table below to indicate courses that you believe meet the prerequisite requirements. These courses must appear on your official transcripts. Contact the GCAP program office if you have questions regarding the suitability of any prerequisite courses (not appearing in the approved list) that you wish to have considered for this application. Additional information on your courses (such as course outlines) may be required. COURSE CONTENT INSTITUTION COURSE NUMBER COURSE TITLE Developmental Psychology Learning Psychology Counselling Theories/ Personality Theories Abnormal Psychology In addition to completing the applicable form above/below, your request for prerequisite review to Include the name of the institution, course number, course title, year completed, and prerequisite area (eg. Counselling Theories). 4. Please complete the table below to indicate Approved Graduate Prerequisites. These graduate courses must appear on your official transcripts. APPROVED GRADUATE PREREQUISITES

10 10 of 18 2/14/ :44 AM COUNSELLING THEORIES: PROFESSIONAL ETHICS: COUNSELLING SKILLS: MULTICULTURAL COUNSELLING: t Available... t Available... t Available... t Available If you do not have an Approved Graduate Prerequisite in one or more areas, please complete the table below to indicate courses that you believe meet the prerequisite requirements. These courses must appear on your official transcripts. COURSE CONTENT INSTITUTION COURSE NUMBER COURSE TITLE Counselling Theories Professional Ethics Counselling Skills Multicultural Counselling WORK EXPERIENCE te: You must provide complete information about your work experience. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application (e.g., you are not currently employed). your work experience is complete. 1. What is your current occupation? 2. Are you currently employed? If, please provide the following information about your current employer. ORGANIZATION NAME CURRENT POSITION EMPLOYMENT STATUS Full-time Part-time Current Employer Address Address: City/Town: Prov/State: Postal/Zip: Country: 3. Please list all relevant work experience beginning with your current employer. EMPLOYER DATES (DD/MM FULL-TIME EQUIVALENT DESCRIPTION Employer Name and Address:

11 11 of 18 2/14/ :44 AM Employer Name and Address: Employer Name and Address: Employer Name and Address: Employer Name and Address: Employer Name and Address: Employer Name and Address: COUNSELLING EXPERIENCE Preference is given to applicants who have 2 or more years of full-time experience in counselling or a related field or 2 years or more of full-time experience in a related health discipline PLUS volunteer or part-time counselling experience. te: You must provide complete information about your counselling experience. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application (e.g., you have no counselling experience). your counselling experience information is complete. 1. Please summarize your paid counselling experiences below. List the full-time equivalency in terms of number of months and years. EMPLOYER AND LOCATION POSITION AND DATES (DD/MM FULL-TIME EQUIVALENT COUNSELLING DUTIES AND RESPONSIBILITIES

12 12 of 18 2/14/ :44 AM 2. Please summarize your volunteer counselling experience below: EMPLOYER AND LOCATION POSITION AND DATES (DD/MM FULL-TIME EQUIVALENT COUNSELLING DUTIES AND RESPONSIBILITIES

13 13 of 18 2/14/ :44 AM PUBLICATIONS AND PRESENTATIONS your publications and presentations are complete. Using no more than 1250 words describe your research background, including relevant education (e.g., courses, workshops) and experience. To assist in editing and avoid potential loss of information, you may wish to draft your personal essay on your local computer, save it to your hard drive, then copy and paste the text in the box below. Please use the word count feature in your word processing software to ensure you do not exceed the allowable 1250-word limit. Include publications, conference presentations, and other scholarly works. For any publications where you were not the primary author, describe your role and contributions to the study. If you have completed a thesis-based Masters degree, include the abstract of your thesis as an appendix. If your thesis is available online, include the URL. PROFESSIONAL DEVELOPMENT te: Please provide complete information about your professional development activities. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application. your professional development information is complete. 1. Provide a list of training/educational experiences that relate to your career and educational goals (e.g., courses, workshops, certificates). Use the buttons under the table to format your list.

14 14 of 18 2/14/ :44 AM 2. Please list all memberships in relevant professional organizations. PERSONAL DEVELOPMENT te: Please provide any additional information about your personal development activities. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application (e.g., you are not currently employed). your personal development information is complete. 1. List all relevant volunteer or community roles and activities. 2. Identify any additional informal activities or life experiences that relate to your career and graduate education goals. PROFESSIONAL EXPECTATIONS As students entering a professional program, you must meet the standards set by the profession. Your responses to the questions below may not have an impact on your admission to the program; this assessment will be made on a case-by-case basis. te: You must provide complete information about your background. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application (e.g., you have never been disciplined by a professional body). your professional standards information is complete.

15 15 of 18 2/14/ :44 AM 1. Have you ever been disciplined by a professional body or been asked to withdraw from an educational program? If yes, please supply the following information: PROGRAM OR PROFESSIONAL BODY REASON FOR WITHDRAWAL OR DISCIPLINE DATE (DD/MM OUTCOME RATIONALE FOR PROGRAM APPLICATION You are required to submit a personal essay of no more than 600 words (approximately two pages double spaced) explaining why you should be admitted to this program. The scholarliness of your response will be evaluated during the application review process. Grammar, spelling, punctuation, clarity of writing, and organization of the essay will be considered. To assist in editing and avoid potential loss of information, you may wish to draft your personal essay on your local computer, save it to your hard drive, then copy and paste the text in the box below. Please use the word count feature in your word processing software to ensure you do not exceed the allowable 600-word limit. te: Remember to click "Save" at the bottom of this section to save your entries. Do not click "Finalize" until you are satisfied that your rationale is complete. 1. Applicants to the Post-Masters Certificate in Counselling should include the following in their personal essay : Your primary reasons for applying to the Graduate Centre for Applied Psychology, Post-Masters Certificate in Counselling program; The specific skills, resources, and experiences that will facilitate your success in this program; What your personal and professional aspirations are and how participation in this program relates to your future career goals? How you plan to balance other competing factors in your life or work with the demands of this program. You must also describe how you embody the GCAP Statement of Professional Expectations, including any areas for growth or change. 2. If you have additional information that is relevant to your application, please enter it here. (Please limit your comments to 100 words or less.)

16 16 of 18 2/14/ :44 AM SCHOLARSHIPS AND GRANTS te: Do not leave this section blank even if you have not received scholarships or grants. Enter "NA" if a question is not applicable to your application. your scholarships and grants are complete. 1. Provide a list of all awards, scholarships, grants, and other academic honours you have received. Please list in order, beginning with the latest. TITLE GRANTING BODY AMOUNT (IF APPLICABLE) COMPUTER REQUIREMENTS Please review the information on Computer Requirements prior to completing this section. te: You must respond to each question in this section. Do not leave any sections blank. Enter "NA" if a question is not applicable to your application. your transcript information is complete. 1. Do you have regular access to a computer? 2. Do you currently have an Internet service provider? It is the responsibility of each student to have access to a computer system equivalent to that noted in our Computer Requirements. 3. Does your computer system currently meet these requirements?

17 17 of 18 2/14/ :44 AM 4. If no, are you committed to obtaining the necessary upgrades to meet these requirements prior to the program start date? MARKETING INFORMATION You are not required to complete this section; however, the information you provide is valuable to our program planning and recruitment. your entries are complete. 1. How did you find out about this GCAP Program? Please check all applicable items: AU Calendar Friend Canadian Virtual University Co-worker Professional Association Employer Internet Relative AU Employee AU Student Program Alumnus Advertisement in print publication (please specify source): Other (please specify): 2. Did you attend an Athabasca University information session? if yes, please indicate location: 3. Please check all the applicable factors that affected your decision to apply to GCAP: Cost Ability to study & continue to work Build own study plan Web-based delivery model Fewer on-site requirements Reputation of AU Flexible study schedule Student recommendation Distance Delivery Integrated curriculum Other (Please specify): 4. What is your main source of media? TV Radio Internet Newspaper Magazines Other (Please specify): CHECKLIST AND APPLICATION SUBMISSION Program: Post-Masters Certificate in Counselling (PMC) Application status: not submitted Application Administrator Comments:

18 18 of 18 2/14/ :44 AM You may verify below which components of the application package have been completed or received. The components that are submitted online will be marked as "finalized" once you finalize that section of the application. Remember, this does not mean the information is complete. You must double check each section to ensure all of your data has been entered and saved. Hardcopy materials must be assembled and packaged by the applicant. Do not send hardcopy application materials separately. Hard copy materials will be tracked as received only after the complete assembled package has been received by our program office. Please allow sufficient time for application components to be received. Mail or courier your complete hardcopy package to the Graduate Program Office. IMPORTANT: Finalizing all elements of the application does not mean you have applied to the program. When you have completed the entire application process, you must click on the "Proceed to Final Review" button on the Application Checklist / Status Sheet. A. Components of the Online Application Form Click to complete the various sections of the Online Application (listed below). Demographic Information Transcripts Letters of Reference Academic History Advance Credit Assessment Program Prerequisites Work Experience Counselling Experience Publications and Presentations Professional Development Personal Development Professional Expectations Rationale for Program Application Scholarships and Grants Computer Requirements t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized t Finalized B. Application Materials Tracking Below you can find tracking information for the materials that match the content of your application. Letters of Reference You must click "Proceed to Final Review" to submit your completed application. Before you do, please double check each section to ensure that you have answered all questions and saved and finalized all of your data.

1 of 18 2/14/2014 11:33 AM

1 of 18 2/14/2014 11:33 AM 1 of 18 2/14/2014 11:33 AM ATHABASCA UNIVERSITY. CANADA'S OPEN UNIVERSITY. Welcome, You have 1 incomplete application. Please click on the one that you want to edit. Then open the "Welcome" message for

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