To determine if UMS and you are a good match, UMS uses the following criteria to evaluate each applicant s completed application:

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1 Dear Applicant, Welcome to your next step in the enrollment process with the University of Mount Shasta in the one year Holistic Healing, Spiritual Psychology, and Empowerment Coaching Masters Program. We at UMS look forward to sharing this valuable and rewarding educational experience with you. To determine if UMS and you are a good match, UMS uses the following criteria to evaluate each applicant s completed application: Personal Honesty Commitment to life-long learning Prior successful academic coursework Ability to think clearly, speak and write well in English Emotional/psychological maturity, including interpersonal competencies, attributes, and skills necessary to be successful in an academic Graduate Program with experiential components Agreement to be drug and alcohol free 24 hours in advance and during all classes. (Medical situations are considered) Two or more references from past professors or professional colleagues Submission of this completed UMS Application One or more letters of recommendation from a past professor or professional colleague. A Bachelor s degree from an accredited, state-approved, or acceptable foreign institution (U.S. Bachelor s equivalent) (send copy of diploma) If you are seeking Admission as a non-degree student, you will be required to complete all the same assignments as graduate students to receive your CERTIFICATE OF COMPLETION (COC). Because of UMS s commitment to an excellent education, enrollment in our Local Master s Program is limited to 35 students and Online Program is limited to 21 students for year, and these spaces are expected to fill quickly. Therefore, we strongly encourage you to begin your application process as early as possible to receive priority consideration for admission. Applications are currently being reviewed. You, as a prospective student, are required to complete and submit your Application, Letter of Recommendation, and $465 Registration Deposit within 30 days of registering (or before October 26, 2015) Receipt of your Registration Deposit and your completed Application for Admission reserves your space in the class pending your acceptance to the University. Page "1

2 In order to complete the Application for Admission, here are your next steps: Review this letter and Application for Admission thoroughly. Pay the $465 application fee (applied to your first month of classes if you are accepted.) Print out all 11 pages of the Application for Admission (and Cover Sheet) on 8 1/2" by 11" white paper. Complete, make a copy for yourself, and mail in or hand deliver the Application for Admission in its entirety. (Faxed or ed applications are not accepted). Request that the Letter of Recommendation be mailed to UMS. Please note that letters of recommendation may also be submitted electronically. See Application Instructions for details. Follow up to ensure your Letter of Recommendation has been submitted. It is our intention to support you in successfully completing the application process. If you have any questions, please contact the Office of Admissions at (530) Thank you again for choosing to participate in Soul-Centered Education at the University of Mount Shasta. We look forward to receiving your completed Application for Admission as soon as possible! Warm regards, Joa Janakoayas, MA., President Page "2

3 How to Apply: APPLICATION COVER SHEET Please complete: 1. APPLICATION FORM Complete the M.A. Application for Admission. Check whether you are applying for a Masters Degree in Spiritual Psychology or for COC Certificate of Completion. COC Students are taking the Program for personal development and professionalism in their field, and not for credit. The application procedure for the online Masters Program is exactly the same. Please type or print legibly. 2. PERSONAL HISTORY Using the enclosed format, please complete the questions on your Personal History. Please type only. 3. PRESENT LIFE EVALUATION and WHEEL OF LIFE Using the enclosed format, please retype and answer the questions on Present Life Evaluation. Please type only. 4. PURPOSES AND INTENTIONS Using the enclosed format, please retype and answer the questions on Purposes and Intentions. Please type only. 5. CLASSROOM AGREEMENTS Please indicate if our suggested classroom guidelines are agreeable with you. 6. PHOTOGRAPH Attach a color photograph of yourself (head shot) taken within the last six months prior to the application. The accepted photo size is 4 x 6, or 3 x 5 7. APPLICATION DUE DATE Completed applications are due within 30 days of registration or October 26, 2015, whichever is sooner. 8. FINANCIAL AGREEMENT AND PAYMENT Review and elect your payment option and sign the Cancelation Policy. When you have completed the application, attach a $465 enrollment fee made payable to UMS. If you are paying with a check or money order, please attach your payment to the space indicated on the Financial Agreement Sheet. In order to be considered, your completed application must be accompanied by your Application Fee. If your application is not complete by October 26, you will be charged a $100 late fee. Page "3

4 9. ENGLISH TEST After completing this application and conversing with the UMS Admissions Counselor, applicants whose native language is not English may be required to take the Test of English as a Foreign Language (TOEFL). Minimum TOEFL scores for admission are 500 on the paper test, 200 on the computer test, or a total score of 80 on the Internet-based test (with a minimum of 19 on each of the four test components). For more information about TOEFL, call (609) or access their Web site at LETTER OF RECOMMENDATION At least one Confidential Letter of Recommendation is required. You can send up to three. You must complete the first section of this form. Give it to the person whom you have selected to recommend you. Please have them fill in the requested information and answer questions 1 through 7 on the Confidential Recommendation form to be sent directly by mail or to UMS. The Recommendation should be from a person who has experience in working with you professionally and/or academically. An academic recommendation may be from someone who has been directly involved with your learning or growth process. Examples of eligible recommenders could include professors, supervisors, business associates, colleagues, counselors/ therapists, life coaches, etc. Recommendation letters from family members or from UMS faculty or staff are not accepted. Ask the recommender to complete both Sections 2 and 3, sign, and mail the completed form with their accompanying letter directly to UMS. You may also submit the completed letter of recommendation electronically. Please the form to the recommender. The recommender may complete the form, write the letter of recommendation, and send these pages via to: info@universityofmountshasta.org PLEASE NOTE: The recommender s signature is required on the form. Page "4

5 APPLICATION Check which program you are applying for: MASTERS DEGREE PROGRAM - Local MASTERS DEGREE PROGRAM - Online COC PROGRAM (CERTIFICATE OF COMPLETION) - Local COC PROGRAM (CERTIFICATE OF COMPLETION) - Online ATTACH PHOTO HERE Please answer in TYPE or PRINT legibly. We, the staff and faculty of UMS promise your personal information will be kept strictly confidential. Please check one option that best applies to you: I am applying to UMS to graduate as a professional Holistic Healer, Spiritual Psychology Counselor and Life Empowerment Coach and for my personal growth and life mastery. I am applying to UMS mainly for my personal growth and life mastery, and I plan to graduate. I am applying to UMS for my personal growth and life mastery and I need more time to decide whether I will graduate. I am applying to UMS mainly for my personal growth and life mastery, and I do not plan to complete the program and graduate. Date Legal Name Nick Name FIRST MIDDLE LAST Mailing Address STREET OR P.O. BOX CITY STATE ZIP Phone: Home Work Mobile Address Birth Date Birth Place Country of Citizenship: Female Male Married Single Other: Occupation: Employer NAME ADDRESS Is English your native language? Yes No If no, TEOFL Score Page "5

6 In case of emergency contact: NAME ADDRESS TELEPHONE NUMBER Have you ever been convicted of a Felony or Misdemeanor offense in California or any other state or place? Yes If you answered Yes, please attach information regarding this. A Yes answer to the question does not mean the automatic rejection of your application. No I understand that letters of recommendations are to be received and maintained in confidentiality by the University of Mount Shasta for admissions consideration. The University prefers your letter(s) of recommendation without your examination to support greater credibility. Please check one below: I waive my right to examine Letters of Recommendation. I do not waive my right to examine Letters of Recommendation. EDUCATIONAL BACKGROUND Please list all the education institutions you have attended starting with high school, whether you graduated or not. DATE MAJOR / DEGREE GRADUATED? INSTITUTION CITY STATE COUNTRY Please list all other professional or educational training and any licensing or certification, particularly in the Healing, Counseling, and Coaching Fields: Has any college dismissed you or asked you to withdraw? YES* NO *If you answered Yes to the question above, please attach information regarding this. A Yes answer to the question does not mean the automatic rejection of your application. Page "6

7 WORK HISTORY Please briefly describe your work history, including your previous employment. Please briefly describe any volunteer experience you have had. How is participating in UMS s Program an outgrowth of your present or previous career? I certify that I have carefully considered each question and that my statements are true and complete to the best of my knowledge. Furthermore, I understand that cancellation of my admission privileges may result if any information is found to be incomplete or inaccurate. If accepted, I agree to abide by the policies and guidelines of the University of Mount Shasta. APPLICANT S SIGNATURE DATE Page "7

8 PERSONAL HISTORY To be completed by all applicants. APPLICANT S NAME DATE Please answer each item below thoroughly. On a separate sheet of paper, type each question singlespaced and bold-faced. Be sure to number each question. TYPE your response below each question, double-spaced. Please staple your response paper to this sheet, sign and date the form where indicated, and submit with your application. 1. Please describe any personal growth-oriented seminars, workshops, or large group educational experiences in which you have participated. 2. Please describe any current health issues and label the intensity of each on a scale from 1 - barely noticeable to 10 - extremely traumatic. 3. a. Please describe any challenging events or situations you may have experienced (including, but not limited to, abuse, violence, chemical dependence, addiction, divorce, anxiety, or depression). Do you smoke or ingest any mood altering substances on a regular basis? If so what are your thoughts and beliefs about this behavior? b. Have you sought support or assistance to resolve or cope with these challenges? If so, please describe and give your evaluation of the effectiveness. c. Please discuss how you adapted or responded to these situations and how you perceive they may be influencing you now. APPLICANT S SIGNATURE DATE By my signature above, I certify that the information contained in my Personal History is true, accurate, and complete. I understand that my giving false or misleading information regarding my Personal History is grounds for denial of admission or dismissal from the Program after admission. I understand that I may be required to participate in an admissions interview prior to acceptance to the Program. Page "8

9 PRESENT LIFE EVALUATION To be completed by all applicants. APPLICANT S NAME DATE Please answer each item below thoroughly. On a separate sheet of paper, type each question singlespaced and bold-faced. Be sure to number each question. Type your response below each question, double-spaced. Please staple your response paper to this sheet and the following Wheel of Life page, sign and date the form where indicated, and submit with your application. Please note the following questions are subjective. What matters most is you are honest about your outer world reality as well as your inner feelings about it. (Note: If you score every section of your Life Wheel as a 10, you will will not be accepted into UMS because you will have essentially declared you have nothing to learn.) If you need more help with the instruction feel free to contact the college for support. 1. Rank your level of satisfaction with each life area as instructed on the Wheel of Life. For each area of your life, please explain why you scored it as you did (not higher or lower) and what emotion(s) you feel as you reflect on it. 2. Which areas of your life, if upgraded, would transform your life the most? 3. Which three areas of your life do you desire to upgrade your level of satisfaction the most, starting with the area of your highest priority? 4. If time, money, and resources are not a concern, describe the things you long to do the most. Be as thorough as you like with answering this question. APPLICANT S SIGNATURE DATE By my signature above, I certify that the information contained in my Personal History is true, accurate, and complete. I understand that my giving false or misleading information regarding my Personal History is grounds for denial of admission or dismissal from the Program after admission. I understand that I may be required to participate in an admissions interview prior to acceptance to the Program. Page "9

10 WHEEL OF LIFE Eight sections of the Wheel of Life represent different aspects of your present life. Seeing the center of the Wheel as the number 1 and the outer edge as 10, rank your level of satisfaction with each life area by drawing a line to create a new outer edge, and place the number rating on it. If you need more help with the instruction feel free to contact the college for support. Page "10

11 PURPOSES AND INTENTIONS To be completed by all applicants. APPLICANT S NAME DATE The following questions are designed to provide information that will assist the University in identifying what it is about UMS that makes its Programs attractive to prospective students. Please answer each item below thoroughly. On a separate sheet of paper, type each question single-spaced and bold-faced. Be sure to number each question. Type your response below each question, double-spaced. Please staple your response paper to this sheet, sign and date the form where indicated, and submit with your application. 1. How did you first hear or become aware of the UMS Program? Please provide the name(s) of the person(s), if applicable. 2. What has led you to apply to UMS s Program in Holistic Healing, Spiritual Psychology, and Life Empowerment Coaching at this time? What do you hope to gain? 3. How do you see UMS s courses in Holistic Healing, Spiritual Psychology, and Life Empowerment Coaching assisting you in making a more meaningful contribution in our world? 1 APPLICANT S SIGNATURE DATE By my signature above, I certify that the information contained in my Purposes and Intentions is true, accurate, and complete. Page "11

12 CLASSROOM AGREEMENTS To be completed by all applicants. UMS s Spiritual Psychology Masters Program is designed to challenge students to let go of their obstacles to living their greater potential for real world happiness. We welcome students who are truly committed to their growth, happiness, and success. Answering the following agreements will help the University to determine whether UMS and you are a good match. We suggest that you also carefully consider most of these agreements as a strategy for life. As a student of the University of Mount Shasta I agree to attend all classes, show up on time, and stay for the agreed duration of each class unless I make previous arrangements or have an emergency. 2. I agree to raise my hand and wait to be called upon before speaking to avoid disrupting our group processes. (Local Students Only) 3. I agree to play at 125 percent! (to allow myself to joyfully expand beyond my mind s comfort zone) Y N Y N Y N 4. I agree to be honest with myself and others at all times to the best of my ability. Y N 5. I agree to be trustworthy. I choose to make only agreements I am willing and intend to keep. I communicate any potential broken agreements at my first appropriate opportunity. I clear up any broken agreements at my first appropriate opportunity. 6. I agree to refrain from hurting myself or others with my thoughts, words or actions. This includes not judging another person in a harsh manner. If a judgment comes up, I agree to allow myself to be coached by the instructor with this. Y N Y N 7. I agree to use every experience for my learning and growth. Y N 8. I agree to be drug and alcohol free when I arrive and during all classes. Y N 9. I agree to keep all personal information of a confidential nature. Y N 10. I agree to stay committed and say YES! to my highest good. Y N 11. I agree to risk intimacy: Make eye contact, and offer hugs as I feel to. Y N 12. I agree to be fully and completely present, and when I am not, to be coached back here and now. Y N 13. I agree to be enthusiastic! (i.e...filled with my Divinity). Y N 14. I agree to get off it, if I am on it; let go of my need to be right. (No one gets to be wrong.) Y N 15. I agree to find agreement and to come into agreement. Y N 16. I agree to give myself permission to know and understand. Y N 17. I agree to be my big picture fulfilled. Y N 18. I agree to BE ON PURPOSE and to be coached with this. Y N 19. I agree to take charge of my own experience by listening and acting on my deepest truth. Y N APPLICANT S SIGNATURE DATE By my signature above, I certify that the information contained in my Classroom Agreements is true, accurate, and complete. Page "12

13 FINANCIAL AGREEMENT APPLICANT S NAME DATE PAYMENT TERMS (Includes Tuition and all Fees) $465 is to be included with this agreement. If you are accepted, 100 percent will applied to your tuition. If you are not accepted, all money paid will be refunded in full. Please check one option: $3200 paid in full before October 15, 2015 $4.650 via Monthly payments as follows: Due Date Payment Oct 15 $465 (Prepaid Registration Fee) Nov 15 $465 ATTACH Dec 15 $465 Jan 15 $465 CHECK Feb 15 $465 Mar 15 $465 HERE Apr 15 $465 May 15 $465 TOTAL $3,720 MONTHLY PAYMENT OPTIONS Please check one I prefer an automatic withdrawal from my credit card or checking account on the 15th of each month. I prefer to pay online with my credit card each month -manually. I prefer to pay by mail with a check. I prefer to pay in person with a check. I prefer to pay in person with cash. I have enclosed $ Check number: I have enclosed $ Check number: I have enclosed $ via check or money order. I prefer to pay by another method:. REFUND POLICY I (Printed Name) understand the following: If I cancel my enrollment up to five days after the first day of class, I am entitled a refund of all monies paid. If I cancel my enrollment at any time after the cancellation period described above, I am entitled to a refund for all future months I have pre-paid excluding past months and the month I have already begun attending classes in. By my signature below, I certify I have read and understand this financial agreement, and I agree to these financial terms: APPLICANT S SIGNATURE DATE Page "13