This form is for registration and payment by credit card If you prefer to pay by check, please click here.

We are currently accepting Fellowship applications for our wait list only for the academic year 2019-2020. Please send your name and contact information to Kathy Beck at if you would like to be placed on the waiting list.

There is no need to submit an application fee or complete the full application form at this time.


  • Date Format: MM slash DD slash YYYY
  • List the College/University you attended, your Major/Degree and Date of Graduation.
  • List the name of the Institution, Course/Programs, Dates and Supervisors.
  • List your training & professional experiences. Please describe the modalities of treatment provided, ages of clients, length and frequency of treatment, and type and frequency of supervision received.
  • e.g. research, teaching, community work, writing, etc.
  • Describe your reasons for applying to the program, e.g. its relevance to your work, its relationship to career goals, your interest in psychoanalysis, etc.
  • Drop files here or
  • Fellowship Application Fee

  • An application fee is required with the submission of the Fellowship application. Choose the one that is appropropriate:
  • $0.00
  • American Express
  • This field is for validation purposes and should be left unchanged.