Have You Ever Been Convicted Of A Counselor Education Program

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A P P L I C A T I O N F O R A D M I S S I O N
G R A D U A T E D E G R E E P R O G R A M S
Applications may be submitted with the following:
• Completed Application Form
• Application fee of $50 (non-refundable except in California and Arizona*)
* In the state of Arizona, the application fee is refundable if the application is canceled within three business days of the applicant signing the Enrollment Agreement.

Applications are complete and ready for review when all of the following materials have been received (additional materials may be requested from applicants whose GPA is below the required GPA of the program):






All official post-secondary transcripts
• International application materials (if required)
Current résumé (psychology and counselor education programs only)
Three Completed Applicant Recommendation Forms (psychology and counselor education programs only)
Personal/professional statement (psychology and counselor education programs only)
Documentation of employment or access to an organization (DBA, EdD in Education and EdD in Organizational Leader ship programs only)

1. Name

7. Have you ever been convicted of a felony?
If “yes,” please explain on a separate sheet.

Yes

Last

First

Middle

Maiden/Other Name

Social Security Number

2. Current Address
Street
City

State

Zip

No

A “Yes” answer to the above question does not mean the automatic rejection of your application. Applicants should be aware that the licensing requirements of some states may mean that a criminal conviction could restrict your ability to practice in your chosen field. For example, students should be aware that the State of Georgia prohibits licensed psychologists from supervising felons. Therefore, practicum placement may not be possible for students with felony histories.

8. List all high schools and all post secondary schools attended

An official transcript is required from every institution. Attach an additional sheet if necessary.

Valid until:
Day Phone

Evening Phone

Email Address

3. Start Date

Name of Institution
Major

Degree

Date of Degree:

Cum. Credits/Cum. GPA

Name of Institution

4. Select a campus from the dropdown.

Major

Degree

Date of Degree:

Cum. Credits/Cum. GPA

Select a School

5. Have you applied to an Argosy University campus within the past year?
Yes

No

6. Select a program which you are applying.

Name of Institution
Major

Degree

Date of Degree:

Cum. Credits/Cum. GPA

(Note: Not all programs are offered at every campus.)

Certificate of Marriage & Family Therapy

9. How did you hear about Argosy University?

10. Is English your first language?
Yes
Rev. 04/22/2014

No
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A P P L I C A T I O N F O R A D M I S S I O N
G R A D U A T E D E G R E E P R O G R A M S
11. Are you a U.S. citizen or Lawful Permanent
Resident?

12. Have you taken the Test of English as a Foreign
Language (TOEFL*)?

Argosy University requests information regarding citizenship status for funding and admission requirements only. Argosy University does not use this information in any way to exclude prospective students on the basis of citizenship status or any other protected characteristic.

Yes

No

Yes

No

Score Earned
Date of Score

Does not discriminate or harass on the basis of race, color, national origin, sex, gender, sexual orientation, gender identity or expression, disability, age, religion, veteran’s status, genetic marker, or any other characteristic protected by state, local or federal law, in our programs and activities.
See AUprograms.info for program duration, tuition, fees, and other costs, median debt, federal data, alumni success, and other important data.

Transcripts
Conditional admission may be granted to an