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Application for Admission

Please Note: Online application fee of $40 is required.
The fee for paper application is $80. Download the Application For Admission Form

Program to which you are applying:

Doctor of Psychology (Psy.D.):
     
Master of Arts:
 
 
     
Postgraduate Credentials:
 
     
       
 
   
     
  Note: Not all programs have entry points each semester or offer part-time options. For more information, contact the Admissions Office.
Will you be requesting transfer of credits?
   
     
 
 
 
Status of Employment:
 
 
     
       
 

Personal Information:

Name:
 
 
 
Address:
 
 
 
Phone Number:  
 
     
     
 
 
  Please be specific      
Have you ever applied to Phillips Graduate Institute before?
 
     
 
Have you ever attended Phillips Graduate Institute before?
 
     
 
Have you ever been dismissed from a school or college?
   
     
 
 
 

Educational & professional Information:

List in chronological order all colleges attended regardless of whether courses were completed for credit (use additional paper if necessary). It is your responsibility to have all official transcripts of college work sent directly from each college attended to Phillips Graduate Institute, Admissions Office. In addition, students with International credentials must submit an official translation from an approved agency.
Date of Attendance Name of Institute Degree/Units Completed Graduation Date
+ Add More
 
 
 
 
 

General Information:

Please note: Applications for admission to the educational programs offered by Phillips Graduate Institute are evaluated without regard to or discrimination based upon race, color, sex, religion, age, national ancestry or origin, sexual orientation, or physical or mental disability. Information on sex, age, ethnic origin, and citizenship status is for compliance reports in connection with federal regulations pursuant to the Civil Rights Act of 1964, Executive Order 11246 as amended by Executive Order 11375 and Title IX of the Education Amendments of 1972 and Part 86.45 C.F.R., and will not be used to discriminate in admission to or participation in any of the educational programs offered by Phillips Graduate Institute.
 
 
   
 
  Citizenship Status:
   
     
     
     
     
     
     
 
Gender:      
     
     
 
Marital Status:      
 
 
 
         
Ethnic Survey:      
Do you consider yourself Hispanic or Latino?   Select one or more race/ethnicities that apply:
 
 
     
     
     
     
     
     
 
Please read the following statements carefully, then mark them as read:
1.) I understand that if admitted to Phillips Graduate Institute, I must comply with all rules, regulations, and policies of Phillips Graduate Institute. I understand that admission to and matriculation in the program in no manner guarantees successful completion of the program and the awarding of a degree. I hereby affirm that the information supplied by me on this application form is true and correct to the best of my knowledge and understand that omissions or falsification may result in withdrawal of acceptance.
2.) I understand the training for which I hereby make application will not in itself qualify me for the California license as a Psychologist, the California license as a Marriage and Family Therapist (MFT), the American Art Therapy Association’s Art Therapy Registration (ATR) and/or the California Commission on Teacher Credentialing (CCTC) Pupil Personnel Services (PPS) Credential. Programs at Phillips satisfy only the minimum education requirements for the aforementioned licenses, registrations and/or credentials.
3.) It is further recognized by the undersigned that initial acceptance into the program does not obligate Phillips Graduate Institute, nor any of its representatives, to maintain any student in the program if said student is found to be unfit for the program by any reason of personality, academic or attitudinal characteristics, or because of unmet financial obligations.
4.) Three-Day Full Refund Period: California State Administrative Code Section 18809 (a) (4) states that if the enrollee cancels within three (3) working days after registering, provided no classes have been attended or lessons completed, all tuition monies paid will be refunded. Fees are not refundable.
5.) Since this is a program which involves the development of professional potential in interpersonal relationships, I understand that I may be required to attend an interview prior to enrollment in the program.
6.) Any questions or problems concerning this institution which have not been satisfactorily answered or resolved by the institution should be directed to the Superintendent of Public Instruction, State Department of Education, Sacramento, California 95814.
 

Credit Card Information








 
I have completed this application form to the best of my ability, and all information is true and accurate. I am indicating this by entering my initials.
 
 
 


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