University of Nevada, Las Vegas



Couple and Family Therapy Program ApplicationLast Name: FORMTEXT ?????First Name: FORMTEXT ????Cell Phone #: FORMTEXT ?????Alternate Phone #: FORMTEXT ?????Other names Under which Materials may be Submitted: FORMTEXT ?????Address: FORMTEXT ?????Date of Birth: FORMTEXT ?????Nevada Resident: FORMCHECKBOX Yes FORMCHECKBOX NoGender: FORMCHECKBOX Male FORMCHECKBOX FemaleEthnicity FORMCHECKBOX White FORMCHECKBOX American Indian/Alaska Native FORMCHECKBOX Chinese FORMCHECKBOX Japanese FORMCHECKBOX Vietnamese FORMCHECKBOX Guamanian FORMCHECKBOX Black or African American FORMCHECKBOX Asian Indian FORMCHECKBOX Filipino FORMCHECKBOX Korean FORMCHECKBOX Native Hawaiian FORMCHECKBOX OtherGRE scoresVerbal: FORMTEXT ?????Quantitative: FORMTEXT ?????Cumulative GPA: FORMTEXT ?????Highest Degree Obtained: (please include major) FORMTEXT ?????EmployerDates of EmploymentTasks/RolesPhone NumberVolunteer ExperienceAgencyDates of EmploymentTasks/RolesPhone NumberAre you an international student? FORMCHECKBOX Yes FORMCHECKBOX NoHave you ever had a professional license or certification revoked, suspended, or otherwise sanctioned on an ethical/legal charge? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, please explain. FORMTEXT ????? Have you ever been convicted of a felony? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, please explain. FORMTEXT ????? Are you interested in a graduate assistantship? FORMCHECKBOX Yes FORMCHECKBOX NoI understand that submittal of my application does not guarantee admission to the program. FORMCHECKBOX Yes FORMCHECKBOX NoI understand that I am to submit transcripts and 3 letters of Recommendation FORMCHECKBOX Yes FORMCHECKBOX NoI understand GRE scores are to be no more than 5 years old. FORMCHECKBOX Yes FORMCHECKBOX No Thank you for your application! Please make sure you complete the graduate college application (Grad Rebel Gateway), the personal statement, essay on the family, and email this Couple and Family Therapy Program Application, Personal Statement, and Essay on the Family to: mft@unlv.edu ................
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