California State Stipend Application

California State Stipend Application Materials and Information for 2012-13

The California Educational MFT Stipend Program will be awarding stipends of $18,500 each during the 2012-13 academic year for use by recipients to defray the cost of their graduate education. Recipients of the state stipends will complete one year of paid or unpaid employment at a mental health service agency administered by a county of California.

Eligible applicants must graduate with a degree that qualifies them to register as an MFT Intern between July 1, 2012 and June 30, 2013. Other eligibility requirements apply.

MFT Regional Consortium. Phillips Graduate Institute is the administrator of the State Stipend Program in partnership with the regional consortia of MFT schools. The eight regional MFT Consortia include the following: Greater Sacramento, Bay Area, Central Valley, Central Coast, Greater Los Angeles, Inland Empire, Orange County, and San Diego and Imperial Counties. Students awarded a stipend must fulfill the employment obligation by serving the workforce needs of the county or counties represented by that regional consortium. Applicants must attend a MFT school that is a member of its regional consortium and schools are listed under “Qualifying MFT Schools” on the website.

Application Process and Deadline. Interested MFT students need to read the Information on the 2012-13 MFT Stipend Program for information on eligibility requirements, qualifying criteria, selection process, and employment/placement payback obligations.

Service Commitment. The objective of the State Stipend Program is to promote public mental health training and practice to those entering the MFT profession. Therefore, recipients of the state stipends will need to commit to one year of service as an MFT Intern at a mental health agency administered by a county of California. The required year of service can be as a paid employee or as a volunteer. Stipend recipients will be required to sign a payback agreement detailing their service commitment in exchange for receiving the stipend.

Sample Payback Agreement

Federal W-9 Tax Form. Stipend applicants must be eligible to work in California and will need to register with the California Board of Behavioral Sciences as a MFT Intern upon graduation. A completed and signed W-9 federal tax form must be submitted with the application. Educational stipends are not taxable income if used to cover the cost of graduate education.

IRS W-9 Form

Guide for Completion of 2012-13 Stipend Application
The five-page guide assists students in the completion of the stipend application form. Included in this guide is information on completing the student’s identifying information, the student’s qualifying information, and the four required essays. The guide is also intended to serve as a way for students to determine if they have the personal capacities, clinical training and community experience that will make them a strong candidate for the stipend program.

Students are encouraged to consult with their school advisor (listed under “Qualifying MFT Schools” on the website) to receive further guidance on the students’ qualifications and aptitude for public mental health practice. The application form requires the signature of a school advisor to verify the student’s academic standing and anticipated conferral date.

Guide for 2012-13 Application

Application Form by Regional MFT Consortium

Each regional consortium has an application form that includes the county or counties represented by that region. Applicants should use the application form for the region they intend to fulfill their post-degree employment or volunteer placement obligation. Applicants may only submit one application form for the State Stipend Program and may not apply to more than one region.

The student’s school must be a member of a regional consortium. Students should refer to the list of qualifying schools on this website to verify that their school is a member.

Click below to select the appropriate MFT State Stipend Application:

2012-13 Application Form – Greater Sacramento
(MFT Consortium of Greater Sacramento represents the counties of Alpine, Amador, Butte, Calaveras, El Dorado, Nevada, Placer, Sacramento, San Joaquin, Solano, Sutter, Tuolumne Yolo, and Yuba.)

2012-13 Application Form – Bay Area
(MFT Consortium of the Bay Area represents the counties of Alameda, Contra Costa, Humboldt, Marin, Monterey, Napa, San Benito, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, and Sonoma.)

2012-13 Application Form – Central Valley
(MFT Consortium of the Central Valley represents the counties of Kern, Fresno, Kings, Madera, Merced, Mariposa, San Joaquin, Stanislaus, Tulare, and Tuolumne.)

2012-13 Application Form – Central Coast
(MFT Consortium of the Central Coast represents the counties of San Luis Obispo, Santa Barbara, and Ventura.)

2012-13 Application Form – Greater Los Angeles
(MFT Consortium of Greater Los Angeles represents Antelope Valley, San Fernando Valley, San Gabriel Valley, Harbor, Metro Los Angeles, West Los Angeles, East Los Angeles and South Los Angeles.)

2012-13 Application Form – Inland Empire
(MFT Consortium of the Inland Empire represents the counties of Riverside and San Bernardino.)

2012-13 Application Form – Orange County
(MFT Consortium of Orange County represents Orange County)

2012-13 Application Form – San Diego and Imperial Counties
(MFT Consortium of San Diego/Imperial represents the counties of San Diego and Imperial.)