JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Clinical Art Therapy Diploma Program Application Form
Please fill out the following form to submit an application for our Clinical Art Therapy Diploma (CATD) Program.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
GDPR Agreement:
*
I consent to having this website store my submitted information so CiiAT staff can respond to my application.
First Name
*
Your answer
Last Name
*
Your answer
Date of Birth (dd/mm/yyyy)
*
Your answer
Address Line 1
*
Your answer
Address Line 2
Your answer
City
*
Your answer
State / Province / Region
*
Your answer
Postal Code
*
Your answer
Country
*
Your answer
Phone
*
Your answer
Citizenship
*
Your answer
As we cannot provide student loans, would you like more information about payment plan options?
*
Yes
No
We offer quarterly intake for the diploma program. When would you most like to begin the program?
*
April 2021
June 2021
September 2021
January 2022
How did you hear about us?
*
Word-of-mouth (friend/family/colleague)
Social media
Organic search (Google)
Newsletter
Other:
Next
Page 1 of 5
Clear form
Never submit passwords through Google Forms.
This form was created inside of Canadian International Institute of Art Therapy.
Report Abuse
Forms
