Austin AMFT Scholarship Application | IMAGO CLINICAL TRAINING FOR CLINICIANS OF COLOR
For applicants interested in the Clinicians of Color (COC) Imago Relationship Therapy Certification Program. with Michelle Bohls and Linda Lewter

more info here: https://www.lindalewterassociates.com/imago-toc-certification-2023

To apply! 
-Complete application
-email personal statement (see details below) and a copy of your current CV or resume to austinamftboard@gmail.com
-Include a one-to-two-page personal statement expressing your reason for applying, applicable personal and professional experience, how you meet the criteria for the scholarship, how you plan to use your training.

Deadline to apply is December 18, 2022 at Midnight.

Please email austinamftboard@gmail.com with any questions.

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I confirm that I am applying for the following training scholarship: Clinicians of Color (COC) Imago Relationship Therapy Certification Program. 

Clinical Training dates:
Module I: February 9-12, 2023
Module II: April 20-23, 2023
Supervision Day: May 21, 2023
Module III: June 22-25, 2023
Module IV:  August 10-13, 2023
 *
Required
Name *
First and last name
Email *
Phone number *
Address *
License Type, State, and License #. *
Has any claim or suit ever been brought against you for alleged malpractice or professional liability? *
If yes, please explain below.
Current Employer *
Specific Clinical Interests *
Are you actively working professionally with couples? *
Are you a member of Austin AMFT? *
Do you have a desire to expand your understanding of Imago to improve your work with couples, individuals, and families? *
Which of the following eligibility criteria do you meet? (select all that apply) *
Required
Tell us about your Social Location *
An individual’s social location is defined as the combination of factors including gender, race, social class, age, ability, religion, sexual orientation, and geographic location.
Describe your Community Involvement *
 We support applicants who have served or are interested in serving non-profit organizations and/or community based groups.
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