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CAMFT
STUDENT AWARD/ SUPERVISOR STIPEND
APPLICATION FORM
Applications and all
supporting materials must be received by CAMFT office by
April 1st, 2005
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CAMFT is not
responsible for lost, late or incomplete applications.
Student and Supervision Applicants must complete the
following table
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Name (last, first,
middle, former)
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Gender:
M___
F___
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Date of Birth:
______/______/______
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Ethnicity:
(African American, Hispanic, Native American, or if
other please specify)
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Home Phone:
(
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Work Phone:
(
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Cell Phone:
(
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E-Mail:
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Name of Institution
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Major Area of Study
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Dates Attended
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Degree
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Date
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UNDERGRADUATE
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MASTERS
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DOCTORAL
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POST-GRADUATE
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Check One: (I am applying
for the) ___
CAMFT Student Award
___ CAMFT Supervision Stipend
Please indicate whom you
have asked to submit supplemental application materials
necessary for completion of your application to the CAMFT
Student or Supervision Award
TRAINING DIRECTOR:
(Student Applicants Only)
__________________________________________
REFERENCE ONE:
____________________________________________________________________
REFRENCE TWO:
____________________________________________________________________
Signature of Applicant:
_________________________________________________Date:____________
To be considered for the
CAMFT Student or Supervision Award, this completed application
form and all required supplemental materials must be received in
the CAMFT office by
April 1st, 2005
. Incomplete
applications will be disqualified.
Send application materials REGULAR MAIL to:
CONNECTICUT
ASSOCIATION FOR MARRIAGE AND FAMILY THERAPY
Attention:
Student/Supervision Awards
P.O. Box 96
Newton
,
CT
06470
2005-2006
CAMFT STUDENT AWARD/ SUPERVISOR STIPEND
The
Connecticut Association for Marriage and Family Therapy (CAMFT)
proudly announces a call for applications for the CAMFT Student
Diversity Award and Supervisor Stipend for the 2005-2006
academic year. Recipients
must be AAMFT (and therefore CAMFT) members.
The CAMFT Board of Directors and Diversity Committee are pleased
to offer persons from underrepresented groups in MFT training
programs the opportunity to pursue training for the profession
of marriage and family therapy.
Each year, CAMFT will provide:
1)
One
Student Award- awarded to a currently enrolled student in an
accredited Connecticut MFT training program ($1,000 cash award
and complimentary admission to the CAMFT Annual Conference)
2)
One
Supervisor Stipend- awarded to a supervisor in training in CT
($1,000 cash award and complimentary admission to the CAMFT
Annual Conference)
Applicants
may apply for either a student award or supervisor stipend but
not both in the same year. Award
and Stipend winners will be recognized at the 2005 CAMFT annual
conference and featured in the CAMFT newsletter. An
applicant that receives an award; agrees to attend at least two
Diversity Committee meetings during the Fall of 2005 or Spring
of 2006.
Eligible
individuals include but are not limited to international
students, minority students, and students who belong to
underrepresented groups in the field of marriage and family
therapy.
Applicants
for the student award must be enrolled in a CT graduate
degree-training program or post-degree training program in
marriage and family therapy during the 2004-2005 academic year.
Applicants
must show promise in and commitment to a career in marriage and
family therapy. This
may be demonstrated by any or all of the following: enrollment
in a training program accredited by the commission on
Accreditation for Marriage and Family Therapy Education,
membership in the AAMFT, work experience or future goals.
Applicants
for the supervision stipend must be AAMFT supervisors in
training.
Potential
stipend applicants who are not already a supervisor in training
must apply by submitting a Supervisor
Candidate Verification Form, available in the AAMFT Approved
Supervisor Designation Standards and Responsibilities Handbook.
To
apply for the CAMFT Student Award, only one official
transcript is required.
Please submit five copies of all other application
materials (including references) requested below:
ü
A
completed award/stipend application form
ü
A
current resume
ü
A
letter of reference from two professional colleagues
ü
A
letter of reference from the Director of the training program of
the applicant’s school affirming your academic status and
including an assessment of your commitment to the field of
marriage and family therapy, as well as a statement of your
potential as a marriage and family therapy.
ü
A
detailed personal statement including how your particular
background has had an impact on you and your career decision.
Please include your professional interests, goals and commitment
to the field of marriage and family therapy.
Explain how the fellowship will further your education
(financial need).
ü
One
official transcript of all graduate work
To
apply for the CAMFT Supervision Stipend, please submit
five copies of the following application materials (including
references):
ü
A
completed award/stipend application form
ü
A
current resume
ü
Two
letters of reference from professional colleagues
ü
A
personal statement (not to exceed two single spaced typed pages)
describing your future plans for marriage and family therapy
practice. Plans to
provide supervision to students from underrepresented groups
will be considered in the application review process.
ü
Please
submit a statement describing your financial need, including
anticipated costs for supervision-of-supervision, current
income, current expenses and financial obligations and other
relevant financial factors such as travel required for
supervision. You
must be accepted as an AAMFT supervisor in training before your
application will be considered.
FINANCIAL
NEED IS ONE OF THE SIGNIFICANT FACTORS TO BE CONSIDERED FOR THE
REVIEW PROCESS FOR BOTH AWARDS.
Applications and all materials must be submitted to
the CAMFT office by April 1st, 2005.
Decisions made by the review committee are final.
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