Center for Spirituality & Psychotherapy
, 330 West 58th St., New York, NY 10019
[Phone: 212-582-1566 Ext 450] [FAX: 212-586-1272]
E-Mail
Application for Admission to the Advanced Training Program for Religious Professionals
of the Center for Spirituality and Psychotherapy
of the National Institute for the Psychotherapies
Please print this form, complete it and mail it in to the attention of CSP.
I. Personal Data Name________________________________________________Date_________ Address______________________________________________ Phone (h)___________(w)_____________Fax__________________Email______ Entry Date applying for_______________ Current Position and Title________________________ II. Education and Training School Degree Field Year III. Pastoral and/or Clinical Experience (use separate page or resume) IV. Summary of any Personal Psychotherapy Are you currently in therapy? Supervision? V. Please tell us about your psychospiritual journey, and what led you to this program. What goals (internal and external) and purposes do you feel would be served by completing this program of study? 1-3 pages. VI. Names of three people you will ask to send us a recommendation, who know your work well. Note: Enclose a non-refundable application fee of $50 payable to CSP