AIEFT Scholarship Program Application
Name
*
First Name
Last Name
Pronouns
e.g., they/them, she/her, he/him
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile number
*
Email
*
example@example.com
What degree are you currently studying? / What degree(s) have you completed?
*
What qualification are you studying for? / What is your qualification(s)?
*
Which institution are you studying at? / Which institution(s) did you study at?
*
What year do you anticipate graduating? / What year did you graduate?
*
(For early career mental health professionals only). Please tell us how many years you have been working in the field and describe what kind of work you have been doing.
Which Level One Course are you applying for:
*
Date(s)
Which Level Two Course are you applying for:
*
Date(s)
Please describe how you meet eligibility for this scholarship.
*
Please describe why you require financial assistance to participate in further training with AIEFT.
*
Please tell us about your interest in Emotion Focused Therapy and why you are applying for this scholarship.
*
Office use only
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Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Submit
Should be Empty: