ࡱ> 796O bjbjUU =7׎e7׎e,,qqqqq$%$$$$$$$$&)$q$qq$hhh qq$h$hh,"X$`a&_""$$0%"\S*XS*0X$S*qX$0h$$L%S*, 7: Ӱɴý Graduate Program in Clinical Mental Health Counseling & Graduate Program in School Counseling PROGRAM APPLICATION Name: ___________________________ Phone: (W) ______________ (H)_______________ Address: _____________________________________ State: _______ Zip: __________ GRE Score: Verbal _______ Quantitative _______ Advanced (Optional) _______ Undergraduate GPA: (Overall) _______ (Last 60 Hours) ______ Graduate GPA: ______ Which Specialty Area Program: Clinical Mental Health______ or School Counseling____ Please type. Attach additional sheets if necessary. 1. Why are you applying to the program? 2. Describe personal qualities and professional experience or training that would be assets to the program and the profession. 3. What personal or professional qualities do you possess that you feel would need to be strengthened to function effectively as a counselor in a counseling? 4. How do you conceptualize the counseling relationship between a client and counselor? 5. What are your eventual career goals? 6. What does culture mean to you? 7. How will you respect the worldviews and cultures of others in the program and in professional settings? 8. There are a limited number of graduate assistantships available. Do you want to apply for an assistantship? ______ YES ________ NO 9. List the name and phone number of the persons you have asked to complete the reference rating forms. Name Phone Number Your Relationship How long you have With this Person known this person 1. ______________________________________________________________________ 2. ______________________________________________________________________ 3. ______________________________________________________________________ This application is true and correct to the best of my knowledge. I understand that acceptance to the Graduate Studies at Ӱɴý does no imply acceptance to the Masters in Clinical Mental Health Counseling Program. _____________________________________ __________________________ Signature Date #PQxyz 6 7 k l m ǺufZKC;hROJQJhaLOJQJh*"h{CJOJQJaJhCJOJQJaJh*"hCJOJQJaJh*"h{5OJQJh{5OJQJh5OJQJh*"h5OJQJh*"hOJQJh*"h{5CJOJQJaJh{5CJOJQJaJh5CJOJQJaJhR5CJOJQJaJh*"h5CJOJQJaJh*"hCJ$OJQJaJ$QSyz9 : 7 l m  h1$7$8$H$gd 1$7$8$H$gd $1$7$8$H$a$gd      ! " ! " # K h1$7$8$H$^h`gd h1$7$8$H$gd 1$7$8$H$gd   # $ % J K N O v w ^hh*"h5CJOJQJaJh*"haLOJQJhOJQJhaLOJQJhROJQJh*"hOJQJh{OJQJK L M N s t u v J 1$7$8$H$gdh1$7$8$H$^hgdh1$7$8$H$^h`gd h1$7$8$H$gdMN1$7$8$H$^`gd 1$7$8$H$gdh1$7$8$H$^h`gd 1$7$8$H$gd ;0P:p/ =!"#$% Dpw666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@6666_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontRiR  Table Normal4 l4a (k (No List PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VGRU1a$N% ʣꂣKЛjVkUDRKQj/dR*SxMPsʧJ5$4vq^WCʽ D{>̳`3REB=꽻Ut Qy@֐\.X7<:+& 0h @>nƭBVqu ѡ{5kP?O&Cנ Aw0kPo۵(h[5($=CVs]mY2zw`nKDC]j%KXK 'P@$I=Y%C%gx'$!V(ekڤք'Qt!x7xbJ7 o߼W_y|nʒ;Fido/_1z/L?>o_;9:33`=—S,FĔ觑@)R8elmEv|!ո/,Ә%qh|'1:`ij.̳u'k CZ^WcK0'E8S߱sˮdΙ`K}A"NșM1I/AeހQתGF@A~eh-QR9C 5 ~d"9 0exp<^!͸~J7䒜t L䈝c\)Ic8E&]Sf~@Aw?'r3Ȱ&2@7k}̬naWJ}N1XGVh`L%Z`=`VKb*X=z%"sI<&n| .qc:?7/N<Z*`]u-]e|aѸ¾|mH{m3CԚ .ÕnAr)[;-ݑ$$`:Ʊ>NVl%kv:Ns _OuCX=mO4m's߸d|0n;pt2e}:zOrgI( 'B='8\L`"Ǚ 4F+8JI$rՑVLvVxNN";fVYx-,JfV<+k>hP!aLfh:HHX WQXt,:JU{,Z BpB)sֻڙӇiE4(=U\.O. +x"aMB[F7x"ytѫиK-zz>F>75eo5C9Z%c7ܼ%6M2ˊ 9B" N "1(IzZ~>Yr]H+9pd\4n(Kg\V$=]B,lוDA=eX)Ly5ot e㈮bW3gp : j$/g*QjZTa!e9#i5*j5ö fE`514g{7vnO(^ ,j~V9;kvv"adV݊oTAn7jah+y^@ARhW.GMuO "/e5[s󿬅`Z'WfPt~f}kA'0z|>ܙ|Uw{@՘tAm'`4T֠2j ۣhvWwA9 ZNU+Awvhv36V`^PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!g theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]    K  8@0(  B S  ?bh33Qx6kl!!Qx6kl!! ִvN:?6pBR~Fr p\hhhhhhhhh  ,O-}.9`:[Bq2p">1*1dް("<}()nf즎O(vt@>.Y64F(>()06+P^Y@|pNkd$R t#"K4AvWnl:@'z*^:BlʳNzpCj>ղn?*\4,8@^4'U\nD;]@LDNH).l)maL{Rx @!!!!@UnknownG.[x Times New Roman5Symbol3. .[x ArialkTimesNewRomanPSMTTimes New RomanC.,.{$ Calibri Light7..{$ CalibriA$BCambria Math hP"'G)"'UU124KQP 2!xxv7] Nicholls State UniversityNicholls State Univ.Dr Dustin Reed0         Oh+'0 , L X d p|ӰɴýӰɴý State Univ. Normal.dotmDr Dustin Reed3Microsoft Office Word@캃@V1@X ڔ1@&_U ՜.+,0 hp  Ӱɴý Ӱɴý Title  !"#$%'()*+,-/0123458Root Entry F֧&_:1Table*WordDocument=SummaryInformation(&DocumentSummaryInformation8.CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q