BA in Applied Addiction Studies

BA in Counselling and Psychotherapy

Application Form - September 2010

Each applicant is considered on an individual basis. Potential students are interviewed after receipt of a completed application form. The objective for selection procedure is to ensure, in as far as possible, that the course meets the needs and expectations of the student, and that the student will be able to meet the course requirements.

Applicants are notified (in writing) within one week of interview, on whether they have been successful in securing a place on the course.

Application Details will be treated as confidential

Name:
Address:
Date of Birth:
Occupation:
Telephone:	(H) (W) (M)
Email Address:
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Course Selection
Please enter the course for which you are seeking admission:
	Higher Cert in Applied Addiction Studies BA in Applied Addiction Studies (1 year add on) BA in Counselling and Psychotherapy

Please choose venue below:
	Athlone Dublin City University (DCU) Waterford Institute of Technology (Addiction Studies only) 38, Lwr Leeson St., Dublin 2

Selection criteria include consideration of:

Minimum academic criteria: Literacy to Leaving Certificate level (or equivalent)

(Please select appropriate option below)

Junior Cert (or equivalent)

Leaving Cert (or equivalent)

Primary Degree (BA/BSc)

Masters

Other

Most Recent
Institution Attended:
Title of Course:
Dates of Attendance:
Qualification Achieved:
Attachment:
(Please attach a copy of any qualifications and other certificates you deem relevant)

(Give full details, of all relevant professional / work experience obtained. Include duration and nature of work and level of responsibility). Please note: professional experience is not essential to participate on the course.

Details:
Professional Association Membership:
Professional Accreditation:

There will be a requirement to use computers on the course

(For example to submit typed assignments or research projects). Please answer the following questions, so that we can assess how much support may be needed:

Do you have access to a computer/laptop?		At home?		At work?
Do you have access to the internet?		At home?		At work?
How proficient are you in the use of computers / internet facilities?		Familiar		Slighter

(Please give details of all relevant personal experience. In the case of a prospective participant being in recovery, it will be required that they have at least two years in recovery, before applying to the course. Please note personal experience is not essential to participate on the course.

Details:

Details:

The cost of the Programme is €4650 per year. A non-refundable deposit of €1000.00 will be requested within 14 days of successfully securing a place on the course.

I certify that the information given above is correct and I agree to pay the course fee of €4650 in full.

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