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CIIAT Art Therapy Program Application
Name
Mailing Address
Home Phone
Mobile Phone
Email
Emergency Contact Name
Emergency Contact Phone
Relationship
Programs Of Interest
Pre-requisites Completed
Comments
Education History
College/University
Major/Department
Graduation/Transfer Date
College/University
Major/Department
Graduation/Transfer Date
Comments
Application Check List
Please include all items with your application
A non-refundable Registration Fee of $150 is required of accepted students. Student is responsible to obtain any inoculations that may be necessary for travel. Student is responsible for Travel and Health Insurance if desired. Student is responsible to procure visa, if needed.
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