Office of Admissions
Pacific Graduate School of Psychology
1-800-818-6136

Application for Admission

Application Date:

November 19, 2008

Application Guidelines

PGSP Bachelor of Science Degree Program

Dear Applicant,

Thank you for your interest in the PGSP Bachelor of Science Degree Program at De Anza College. Should you have questions regarding the Program or this application process please feel free to contact the PGSP Admissions Office toll free at (800) 818-6136.

Application Fee

A nonrefundable application fee of $40.00 must be mailed separately in order to complete your application. Checks or money orders should be made payable to "PGSP".

Official Transcripts

Transcripts from all postsecondary institutions attended, even if a degree was not awarded, must be mailed to the PGSP Admissions Office. Only official, sealed transcripts obtained from the Registrar's office of each of these institutions are acceptable. Admissions decisions that are made based on submission of unofficial transcripts will only be provisional until official transcripts are received.

Transcripts and application fees should be mailed to:

Pacific Graduate School of Psychology
Admissions Office - Bachelor of Science Program
405 Broadway
Redwood City, CA 94063

Statement of Purpose

Along with your application, please include a 1-3 page typed statement of purpose written around the theme: "You must be the change you wish to see in the world” (Mahatma Gandhi). What changes do you wish to see in the world and how will a program dedicated to "The science of social action in a global community" help you achieve your personal goals? Please explain what those goals are? You will see the submission area for this at the bottom of the online-application.

References

Please provide the name and contact information for up to 3 individuals who are able to speak to your academic ability and your potential for success in the PGSP Bachelor of Science Degree Program.

* = Required Information

* Term:

Personal Information:

* First Name:

* Middle Name:

* Last Name:

Names on records from previous schools:

* Social Security Number

Current Contact Information:

* Street:

* City:

* State:

* Zip:

* Home Phone:

* Work Phone:

* Fax:

* E-Mail:

Permanent Address (if different)

Street:

City:

State:

Zip:

Country of Citizenship:

Alien Registration Number:

Visa Number:

Educational Background

Please list all colleges attended since high school and all degrees conferred. If you do not have a degree, indicate the total number of units completed at each college. If you are currently working toward a degree, please indicate the degree you expect to earn, and the expected date, in parentheses.

Institution	State or Country	Dates Attended (From/To)	Major	Degree (or units)	Date Degree Received

Recommendations

Please provide the names and addresses of up to three persons who have agreed to serve as a reference. Your references should be able to speak to your academic ability or your potential for success in a field related to the PGSP Bachelor of Science in Psychology Degree Program. At least one of your references should be a professor who has had you in class.

Name	Phone Number	Email Address

Demographic Information

The information below is optional. It is requested for statistical purposes only and will be kept confidential.

Birth Date

Date of Birth (mm/dd/yyyy):

Gender:

Not Specified
Male
Female

Ethnicity:

Not Specified
Alaskan Native or American Indian
Asian or Pacific Islander
Hispanic
African-American
Caucasian
Other (specify)

PGSP practices a nondiscrimination policy regarding physical ability, gender, age, race, color, lifestyle, national and ethnic origins in admission, employment, and in the administration of its program and activities.

Statement of Purpose

Please include a 1-3 page typed statement of purpose written around the theme: "You must be the change you wish to see in the world” (Mahatma Gandhi). What changes do you wish to see in the world and how will a program dedicated to "The science of social action in a global community" help you achieve your personal goals? Please explain what those goals are? You can type your essay below, or copy the text out of your word processor and paste it into the text area below.

Signature Area

I understand that official transcripts of credit earned at other institutions and other documents which have been presented for admission or evaluation become the property of PGSP and are not returned to the applicant.

I certify that the information recorded in this application, the transcripts provided, and all other application materials submitted are correct and complete. By submitting this application, I agree to abide by and be subject to the rules and regulations at PGSP.

Applicant's Signature: _______________________________________

Date: ________________