Elibility and application form

APPLICATION FOR UTS INTERNSHIP - 2007

University of Technology, Student Services Counselling Unit.
Level 6, Tower Building.
15 Broadway, Ultimo  NSW   2007,   Australia.
Ph:  (02) 9514 1177   Fax:  (02) 9514 1172

Training Coordinator:
Ms Sue Doctor
Email: sue.doctor@uts.edu.au

Please note: You may fill in this form and email your application with your CV directly to the Training Coordinator.  The "*" character has been used to designate the places in which you need to enter information. Simply use your word processor to replace each "*" character with the appropriate information.

Application Details:

1. CONTACT DETAILS

   1. Name: *
   2. Home Address: *
   3. Work Address: *
   4. Phone (Home): *
   5. Phone (Work): *
   6. FAX: *
   7. E-Mail: *
   8. Mobile: *

2. EDUCATION

   1. What is the name and address of the university/institution where you are studying?
      *
   2. What is the name of the degree you are studying?
      *
   3. Name of your Placement coordinator:*
      E-Mail: *
      Phone No: *
   4. Registration:
      Do you have Conditional or Full Registration? *

3. ESSAYS

   Instructions: Please answer each question in 500 words or less.
   1. Please describe your direct fact-to-face clinical/counselling experience.
      *
   2. How do you envision the UTS internship meeting your training goals and interests? (If you are addressing these issues in a cover letter, please feel free to refer the reader to the cover letter and do not repeat here).
      *

If I am accepted and become an intern, I expressly agree to comply fully with the Ethical Guidelines and Code of Ethics of the Australian Psychological Society (APS, open an external page).