Psychology
School of Human & Community Development
Private Bag 3, Wits 2050, South Africa. Telephone: +27 11-717-4500/2/3/4. Fax: +27-11-717-4559
Discipline Application Form:
MA (Clinical Psychology)
Please complete all sections below without exceeding the allocated space.
Personal Details
Surname:
First names:
Date of birth: Age:
Nationality:
Marital status:
Number of children (please give ages):
Physical address:
Postal address:
Telephone no: Work: Home: Cell:
Email address:
Racial group: Sex:
Comment on any of the above should you wish to:
Application closing date: 2nd May 2017 for study in 2018
Academic Record
Please do not exceed one page for this section.
Undergraduate degree
University: Majors:
Average mark for third year psychology:
Average mark for psychology research course(s):
Psychology Honours degree
University:
Current or completed? Year completed:
Specify all Honours results obtained in psychology to date:
Average Honours mark:
Other
Please list other degrees, diplomas or relevant qualifications. Specify where they were obtained and final marks received.
An Honours average of at least 65% is required for this application to be considered. This Honours degree must have been completed in the last 5 years.
Relevant Experience
Please do not exceed one page for this section.
What is your present employment?
Specify what professional or clinically related experience, if any, you have had (e.g. volunteer counseling, psychometric training, child care or youth work etc.). Please provide a brief description and indicate where and when you obtained this experience.
What previous research experience, if any, have you had?
Experiences with psychology and psychiatry
Please do not exceed one page for this section.
Please use this section to tell us about any experiences you have had of your own personal psychotherapy. Please also give any details of any psychiatric treatment, including admissions, psychiatric diagnoses and/or medication. Please comment on the extent to which you have resolved these experiences and how they have shaped you as a person.
Interest in Clinical Psychology and Personal Statement
Please do not exceed one page for this section.
What has led you to want to study clinical psychology? How do you understand your strengths and weaknesses as a potential clinical psychologist?
Autobiographical account
Please do not exceed one page for this section.
Provide an account of some of the key experiences that have shaped you as a person.
Sample of writing
Please do not exceed two pages for this section.
Type two pages on any psychological concept that you have found particularly interesting. Define the concept and say why you find it interesting.
References
Two forms have been included for you to send to two people whose professional and academic knowledge of you is such that they will be able to respond meaningfully. Kindly ask the referees chosen to email their response directly to . These must reach us before the closing date.
First Referee’s name:
In what capacity does s/he know you?
Second Referee’s name:
In what capacity does s/he know you?
Application checklist
Your application will be considered complete when:
1. This application is returned in electronic format before the closing date
2. A full academic transcript of undergraduate and Honours results is electronically sent with this application form
3. All referee reports are received by the closing date
4. An online equity questionnaire has been completed. Please visit https://www.surveymonkey.com/r/WitsMAEquity2017 to access questionnaire.
5. A university application form is submitted online to the Student Enrolment Centre (https://www.wits.ac.za/applications/)
Your application cannot be processed unless all of the above have been received.
Email your application (by 2nd May 2017) to .
See www.witsclinselections.wordpress.com for updates.
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