4 Year Program Application Checklist

Thank you for submitting your 4 Year Program Application. The following items below are required to complete your application.
Application Fee Upon completing your application, you should have been directed to a Paypal payment page for the application fee of $55. If you have not yet successfully completed the payment of your application fee, please click here to make your payment.
Name
First Last
Undergraduate Transcripts
PDF, DOC, OR DOCX files only, 5MB maximum size per file.
Drop files here or

Accepted file types: pdf, doc, docx.
Graduate Transcripts
PDF, DOC, OR DOCX files only, 5MB maximum size per file.
Drop files here or

Accepted file types: pdf, doc, docx.
A scanned copy of your current malpractice insurance certificate. (In most cases insurance may be obtained from the American Professional Agency, 95 Broadway, Amityville, NY 11701, 631-691-6400.)
JPG, TIFF or PDF files only, 5MB maximum file size.
Accepted file types: jpg, tiff, tif, pdf, jpeg.
A scanned copy of your NYS License
JPG, TIFF or PDF files only, 5MB maximum file size.
Accepted file types: jpg, tiff, tif, pdf, jpeg.
A scanned copy of your current psychoanalyst’s vita for approval (Your therapist must be licensed in his/her field and be a graduate of a recognized psychoanalytic training program with at least five years of post-graduate experience.)
PDF, DOC, OR DOCX files only, 5MB maximum file size.
Accepted file types: pdf, doc, docx.
Personal Statement
Limited to a single page, no smaller than 10 point font. PDF, DOC, OR DOCX files only, 5MB maximum file size.
Accepted file types: pdf, doc, docx.