APPLICATION for FALL 2018 ADMISSION

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MARRIAGE and FAMILY T P http:/www.uwinnipeg.ca/marriage-family-therapy A Graduate Studies Program of the University of Winnipeg http://www.uwinnipeg.ca/graduate-studies/ 515 Portage Avenue, Winnipeg, Manitoba, R3B 2E9, Canada APPLICATION for FALL 2018 ADMISSION DUE February 1, 2018 Submit to: Graduate Studies Admissions Office Dagmawit Habtemariam, University of Winnipeg 1RC023B -515 Portage Avenue, Winnipeg, Manitoba R3B 2E9, Canada Fax: (204) 774-4134 For further application information, contact Dagmawit Habtemariam. Phone: (204) 786-9309, Email: d.habtemariam@uwinnipeg.ca For program information, contact Dr. Narumi Taniguchi, Program Director n.taniguchi@uwinnipeg.ca Revised 20 October 2017 1

All applicants complete the attached Application for Admission form. The receipt of all required materials is due by 4:30 p.m. on the deadline date or the next business day if the deadline falls on a weekend or holiday. Incomplete applications are not forwarded to the departments for review. To meet the submission deadline, e-mails and faxes are accepted forms of transmission except for transcripts/evidence of degrees awarded. 1. Official academic transcripts for all previous academic work, whether having graduated from the Institution or just having taken courses there, sent directly from the issuing institution(s). If the transcript does not show that a completed degree has been conferred, an official/notarized copy of your diploma is also required. Transcripts must arrive in sealed, endorsed envelopes issued by the home institution(s) in order to be considered official. A 4-year Bachelor degree* from a recognized post-secondary institution with an overall GPA of 3.0* is the minimum requirement. An Honours Bachelor degree, or a Master s degree will be considered an asset. Related training (e.g., a Counselling Certificate) is also an asset. * A 3-year Bachelor degree or a GPA lower than 3.0 may be considered. Please submit Form B. NOTE: Transcripts in languages other than English and French should include a certified English (literal) translation submitted in a sealed envelope with the official stamp and signature of the translator or notary across the seal. 2. Three References (forms included in this package): 1) from an academic advisor or other person with information on your capacity to do Master s level academic work, 2) from an employer or supervisor, and 3) from a person who is qualified to comment on your academic, professional background, and/or your suitability for the program. Official/formal letters of recommendation must be received in a sealed envelope with the referee s signature across the seal, and can be sent directly to the Graduate Admissions Office or be part of the application. 3. The application fee (non-refundable): $100.00 for domestic applicants, $120.00 for international applicants. 4. A Resume: Be specific about employer and volunteer work including dates and whether full or part-time, including percentage part-time. Ideally the resume will give evidence for two or more years of employment or volunteer work connected to therapy and/or with families. 5. An Essay: A brief autobiography (2 5 pages) including a description of your family of origin (i.e., the family in which you grew up), cultural background, health and educational history, and how some or all of that influenced your wish to be a marriage and family therapist. The essay should also include the ways that significant events and/or relationships influenced your development and/or your view of relationships. Your capacity to be self-reflective will be evaluated, not the content of the life experience. 6. (For International Students Only) An official TOEFL or IELTS score: If English is not your first/primary language and you are not from an English Exempt Country, you must provide a minimum TOEFL ibt score of 100, with a score of at least 22 on the writing and speaking component, or PBT score of 600. Alternately, a minimum IELTS score of 7.5 based on the Academic Module is required. English language tests older than two years from the date of application will not be considered. For a complete list of exempt countries please refer the link: http://www.uwinnipeg.ca/futurestudent/international/lang-req.html. REVIEW PROCESS OF APPLICATIONS APPLICATION PROCEDURES Applicants are ranked by points that are allocated in the following categories: 1. Previous academic performance as shown on transcripts 2. Employment and volunteer experiences, especially in the field of helping profession 3. Letters of reference endorsing the applicant 4. Ability demonstrated through an autobiography to reflect on self and recognize family processes 5. Bonus points are given for qualities which add to the program: a) fluency in the language(s) of a Manitoba population group that needs family therapy services, b) meeting a program need (e.g., solving diversity imbalance problem). The applicants are ranked based on the number of points earned from the application. Interviews are scheduled from among those who rank more highly. More than the number we can accept will be interviewed. The points assigned for the interview will be added to the points earned from the application to rank the applicants. Those with higher rankings will be offered acceptance for Fall 2017. 2

THE MASTER OF MARRIAGE AND FAMILY THERAPY PROGRAM GRADUATE STUDIES APPLICATION FOR ADMISSION Send to: Graduate Studies Admissions Office, Dagmawit Habtemariam, University of Winnipeg, 1RC023B -515 Portage Avenue, Winnipeg, MB, R3B 2E9, Canada Email: d.habtemariam@uwinnipeg.ca, Fax: 204-774-4134 Program For Office Use Only UW Student ID Number Part-Time Study Full-Time Study (International Applicants Only - Form A required) Personal Information Legal Last/Family Name: Legal First Name: Legal Middle Name: Previous/Maiden Name: Date of Birth (DD-MM-YEAR): Mailing Address (This will be used for all correspondence.): Apt#, Street or Box # City/Town Province Country Postal Code Phone: Alternative Phone: Email: Current Occupation: Primary/First Language: Other Languages Spoken and Written: Gender: Male Female Other Aboriginal Ancestry Provision of this information is optional. It is used by the University to gain a better understanding of its student body and for statistical purposes. The Aboriginal Student Services Centre (ASSC) offers services, events, and information on source funding that may be of interest to you. By declaring your status, you will help the development of new services, events, and academic offerings for First Nations, Metis, and Inuit students. First Nations (Status) First Nations (Non-Status) Métis Inuit Other Home Community: Citizenship (Confirmation of Permanent Residency is required with this application) Canadian Citizen Permanent Resident or Refugee International Country of Birth: Country of Citizenship: If not born in Canada, Date of Entry (DD-MM-YEAR): - - 3

Accessibility Services Accessibility Services offers support services and resources for students with disabilities or medical conditions. Would you like to be contacted with more information? YES NO Post-Secondary Education List ALL Post-Secondary Institutions attended. Official transcripts are required for each institution attended. Note: - Your application is not complete until we receive official transcripts for all previous academic study (whether you graduated from the Institution or just took courses there) - If any documentation submitted is under a different name than your application, proof of name change will also be required. Post-Secondary Institution City/ Prov/ Country Degree* (e.g., BA, BSc, MA, etc) Major/ program (e.g., psychology, social work, etc.) GPA* Date of Graduation (DD-MM- YEAR) Language of Instruction * Applicants with a 3-year degree or a GPA lower than 3.0 must submit a request for exemption (Form B). Clinical Training Please list any direct counselling related training you have received. Name of Centre/Agency Supervisor Dates Hours of Training Emergency Contact Last/Family Name, First Name Relationship Telephone Number (Including Area Code) 4

Declaration I declare that all statements made with respect to this application are true and complete, that all records are complete and unaltered, and that accepting this declaration permits The University of Winnipeg to request, confirm, and/or share any necessary information with other educational institutions to support my application. If accepted to The University of Winnipeg, I agree to follow University regulations. I accept that misinterpretation, falsification of documents, or the withholding of requested information with respect to this application can result in cancellation of my acceptance and registration or dismissal from the University and that any information on falsifications may be shared with the Association of Registrars of the Universities and Colleges of Canada and/or other postsecondary institutions. I accept this declaration: Personal Information collected on this application will be used by The University of Winnipeg for admission, registration, scholarships, awards, student records, alumni services, university research, housing, and other activities related to being a member of the university community. It may also be disclosed to relevant student associations and federal and/or provincial authorities. It is collected under the general authority of The University of Winnipeg Act, in conformity with, and protection under the Manitoba Freedom of Information and Protection of Privacy Act (FIPPA). Information Release (Optional) You may wish to authorize someone to act on your behalf with respect to application status, registrations, financial information/activities, transcripts or graduation. If you wish to designate someone to act on your behalf, please complete the Information Release Form available on the web: http://www.uwinnipeg.ca/index/cms-filesystem-action/pdfs/studentservices/fippa-and-consent-form.pdf If you have any questions about the collection and the use of this information, please contact: Dan Elves, FIPPA and Records Officer, University of Winnipeg, 515 Portage Avenue, Winnipeg, MB. R3B 2E9 204.988-7538, da.elves@uwinnipeg.ca Date: Signature of Applicant: Application Fee Payment Cheque Credit Card Money Order Student Central (previous UofW students Only) Card Number Expiry Date VISA Master Card Signature: FOR OFFICE USE ONLY: Receipt #: Date: Initials: Date Received: Amount: Cash Cheque Credit Card 5

MASTER OF MARRIAGE AND FAMILY THERAPY PROGRAM Reference Letter 1 (from an academic advisor or other person with information on the applicant s capacity to do Master s level academic work) Due by February 1, 2018 Please return this reference to: Graduate Studies Admissions Office, Dagmawit Habtemariam, University of Winnipeg, 1RC023B -515 Portage Avenue, Winnipeg, Manitoba R3B 2E9, Canada Reference forms can be e-mailed (d.habtemariam@uwinnipeg.ca) or faxed (204.774.4134) to the Graduate Admissions Office to meet the submission deadline; however, official letters will still be required. NAME OF APPLICANT: Please rank the applicant relative to students in a Master s degree program using the following classifications for each item: [4] outstanding (upper 10%), [3] above average (upper 20%), [2] average (upper 40%), [1] below average, [X] unable to judge. [ ] Personal maturity, appropriate for training as a family therapist [ ] Ability to do imaginative problem solving in human relationships [ ] Ability to think critically [ ] Presentation of self as industrious and persevering [ ] Ability to maintain professional standards of practice as a therapist [ ] Verbal and written communication [ ] Overall evaluation of applicant s academic ability relative to similarly trained persons How long have you known the applicant? In what capacity have you known the applicant? Name of Referee (Please Print) Signature Date Address Please use the back of this form for additional comments or attach a letter of reference. 6

MASTER OF MARRIAGE AND FAMILY THERAPY PROGRAM Reference Letter 2 (from an employer or supervisor) Due by February 1, 2018 Please return this reference to: Graduate Studies Admissions Office, Dagmawit Habtemariam, University of Winnipeg, 1RC023B-515 Portage Avenue, Winnipeg, Manitoba R3B 2E9, Canada Reference forms can be e-mailed (d.habtemariam@uwinnipeg.ca) or faxed (204.774.4134) to the Graduate Admissions Office to meet the submission deadline; however, official letters will still be required. NAME OF APPLICANT: Please rank the applicant relative to students in a Master s degree program using the following classifications for each item: [4] outstanding (upper 10%), [3] above average (upper 20%), [2] average (upper 40%), [1] below average, [X] unable to judge. [ ] Personal maturity, appropriate for training as a family therapist [ ] Ability to do imaginative problem solving in human relationships [ ] Ability to think critically [ ] Presentation of self as industrious and persevering [ ] Ability to maintain professional standards of practice as a therapist [ ] Verbal and written communication [ ] Overall evaluation of applicant s academic ability relative to similarly trained persons How long have you known the applicant? In what capacity have you known the applicant? Name of Referee (Please Print) Signature Date Address Please use the back of this form for additional comments or attach a letter of reference. 7

MASTER OF MARRIAGE AND FAMILY THERAPY PROGRAM Reference Letter 3 (from a person who is qualified to comment on your academic, professional background, and/or you suitability for the Program) Due by February 1, 2018 Please return this reference to: Graduate Studies Admissions Office, Dagmawit Habtemariam, University of Winnipeg, 1RC023B -515 Portage Avenue, Winnipeg, Manitoba R3B 2E9, Canada Reference forms can be e-mailed (d.habtemariam@uwinnipeg.ca) or faxed (204.774.4134) to the Graduate Admissions Office to meet the submission deadline; however, official letters will still be required. NAME OF APPLICANT: Please rank the applicant relative to students in a Master s degree program using the following classifications for each item: [4] outstanding (upper 10%), [3] above average (upper 20%), [2] average (upper 40%), [1] below average, [X] unable to judge. [ ] Personal maturity, appropriate for training as a family therapist [ ] Ability to do imaginative problem solving in human relationships [ ] Ability to think critically [ ] Presentation of self as industrious and persevering [ ] Ability to maintain professional standards of practice as a therapist [ ] Verbal and written communication [ ] Overall evaluation of applicant s academic ability relative to similarly trained persons How long have you known the applicant? In what capacity have you known the applicant? Name of Referee (Please Print) Signature Date Address Please use the back of this form for additional comments or attach a letter of reference. 8

MASTER OF MARRIAGE AND FAMILY THERAPY PROGRAM FORM A Full-Time Study Request (International Applicants Only) The Master of Marriage and Family Therapy program at the University of Winnipeg is not currently structured for fulltime study for domestic students. International students requesting full-time study are asked to provide a brief explanation. 9

MASTER of MARRIAGE AND FAMILY THERAPY PROGRAM FORM B - Request for Exemption The minimum admissions requirement for Graduate Studies at the University of Winnipeg is a 4-year Bachelor s degree with an overall GPA of 3.0. The Master of Marriage and Family Therapy program will consider a 3-year Bachelor degree or an overall GPA lower than 3.0 if the applicant presents significant life challenges and circumstances that prevented them from meeting these minimum requirements and if they demonstrate the ability/potential to successfully perform Master s level work. 1. Please briefly describe the reason(s) that you do not meet the minimum requirements. 2. Please provide some examples that demonstrate your ability/potential to successfully perform Master s level work (e.g., earned a grade of an A in all courses taken during the last year of university, taken a few Master s level courses elsewhere and earned A grades, published an article in a peer-reviewed journal, extensive work experience in the field, etc.). 10