Clone of APF Scholarship Application Form Professionals and Students

The Access Psychology Foundation (APF) provides scholarships to licensed mental health professionals and students from historically underrepresented backgrounds, enabling them to access continuing education in leading evidence-based treatments for mental health disorders. Through a partnership with Cognitive & Behavioral Consultants, LLP (CBC) APF offers funding for workshops, trainings, consultations, and continuing education talks led by expert clinicians in Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT).

Eligibility

Applicants must be from a historically underrepresented group
Mental health professional or graduate student

Application Components

Completed APF Scholarship Application
CV/Resume
Letter of recommendation

To apply for this APF scholarship, please complete the following application below in its entirety. Should you have any questions, contact an APF staff member at info@access-psychology.org or call (914) 810-0183.

Applicants will be notified of the status of their application within five business days of submission.

Date of Application:

MonthDayYear

Full Name

First NameLast Name

E-mail :

Where the confirmation will be send to

Mobile No. :

Format: (000) 000-0000.

Home Address :

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Gender:

Are you a US citizen?

Ethnic Origin:

Race? (Choose one or more):

Were you born outside the USA?

If so, what country?

Were your parents born outside the USA?

If so, what country?

Degree (if applicable):

Graduate Student? (If so, please list your degree, institution, and expected graduation date)

Training Program Requested:

Other

If you selected "other", please type the name of the training below:

Have you ever received a scholarship from Access Psychology Foundation?

How did you learn about the Access Psychology Foundation scholarship?

By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.

E-Signature:

Questions?

info@access-psychology.org

Access Psychology Foundation

One North Broadway, Suite 704

White Plains, NY 10607

(914) 810-0163

www.access-psychology.org

Access Psychology Foundation Scholarship Application Form for CBC

I. Applicant Information:

IV. Applicant's E-Signature