Application for Admission - Rivier University
Application for Admission - Rivier University
Application for Admission - Rivier University
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<strong>Application</strong> rivier.edu/PsyD<br />
Division of Education<br />
Doctor of Psychology<br />
in Counseling and School Psychology<br />
Please type or print responses and return your completed application to:<br />
Office of Graduate <strong>Admission</strong>s,<br />
<strong>Rivier</strong> <strong>University</strong>, 420 South Main Street, Nashua, NH 03060-5086<br />
Emailed documents are encouraged and must be sent directly from the primary source (transcripts, letters of recommendation,<br />
essays, and résumés/vitae etc.). Emailed material should be addressed to psyd@rivier.edu.<br />
<strong>Application</strong> Material<br />
1. <strong>Application</strong> <strong>for</strong>m: With a non-refundable $100 application fee. Checks should be made payable to <strong>Rivier</strong> <strong>University</strong>.<br />
2. Official transcripts: From all colleges or universities attended.<br />
3. GRE test scores: Within the last five calendar years in Verbal Reasoning, Quantitative Reasoning, and Analytic Writing,<br />
as well as the Psychology subject test.<br />
4. Current résumé or curriculum vitae: documenting at least three years of professional experience.<br />
5. Statement of Purpose: A three-page essay that states your professional experience and how that experience relates to your<br />
intended doctoral study; your rationale <strong>for</strong> pursuing doctoral study; a statement of a research interest; problem, or question<br />
you intend to pursue through doctoral study or are interested in researching; and the ways in which doctoral study will<br />
contribute to your personal and professional experience and enhance your career goals and plans.<br />
6. Three letters of recommendation:<br />
• One from a present or <strong>for</strong>mer employer who can address your professional experience and leadership potential.<br />
• One from a current or <strong>for</strong>mer professor or colleague who can discuss your ability and potential <strong>for</strong> advanced course work,<br />
scholarship, and research.<br />
• One from someone who can speak to your personal and professional character.
Full Legal Name<br />
Last First Middle<br />
Female<br />
Male<br />
Other names that may appear on supporting documents Email address U.S. Social Security number<br />
Current Mailing Address<br />
Number and street<br />
( )<br />
( )<br />
City State or country ZIP or Postal code Phone number Alternate phone number<br />
Permanent Mailing Address (if different from current)<br />
Number and street<br />
( )<br />
City State or country ZIP or Postal code Phone number<br />
Date of Birth<br />
/ / Place of Birth<br />
Mo Day Year City State or country<br />
Do you wish to be considered <strong>for</strong> financial aid? Yes No<br />
Are you currently enrolled in classes at <strong>Rivier</strong>? Yes No<br />
Proposed entrance date: fall<br />
Year<br />
Is English your native language? Yes No If no, have you taken the TOEFL or IELTS English Proficiency exam? Yes No<br />
Ethnic Background (optional):<br />
The in<strong>for</strong>mation you provide is used <strong>for</strong> data collection and research only.<br />
Are you Hispanic or Latino? m Yes m No<br />
In addition, do you consider yourself:<br />
m Asian (Including Indian subcontinent and Philippines)<br />
m American Indian/Alaska Native or other native person of the Americas<br />
m Black or African American<br />
m Native Hawaiian or Other Pacific Islander<br />
m White (Including Middle Eastern)<br />
m Other<br />
Have you ever been convicted of a felony that has not been annulled? Yes No<br />
If you answered yes, please attach a separate sheet of paper that provides the date of each conviction, the name of the state and the specific court where<br />
the conviction was entered, and the acts leading to the conviction.<br />
Office of Graduate <strong>Admission</strong>s, <strong>Rivier</strong> <strong>University</strong> • 420 South Main Street , Nashua, NH 03060-5086
<strong>Application</strong> rivier.edu/PsyD<br />
| Doctor of Psychology<br />
Previous Higher Education<br />
Please list all colleges and universities you have attended from earliest to most recent. Official transcripts must be requested<br />
<strong>for</strong> each and submitted directly to the Office of Graduate <strong>Admission</strong>s or electronically from the school to psyd@rivier.edu.<br />
1. ______________________________________________________________________________________________________________________<br />
School name City State (or province & country)<br />
__________________________________________________________________________ /_________________________________/________<br />
Subject/major Degree earned Date entered mo/yr Last attended mo/yr.<br />
2. ______________________________________________________________________________________________________________________<br />
School name City State (or province & country)<br />
__________________________________________________________________________ /_________________________________/________<br />
Subject/major Degree earned Date entered mo/yr Last attended mo/yr.<br />
3. ______________________________________________________________________________________________________________________<br />
School name City State (or province & country)<br />
__________________________________________________________________________ /_________________________________/________<br />
Subject/major Degree earned Date entered mo/yr Last attended mo/yr.<br />
4. ______________________________________________________________________________________________________________________<br />
School name City State (or province & country)<br />
__________________________________________________________________________ /_________________________________/________<br />
Subject/major Degree earned Date entered mo/yr Last attended mo/yr.<br />
5. ______________________________________________________________________________________________________________________<br />
School name City State (or province & country)<br />
__________________________________________________________________________ /_________________________________/________<br />
Subject/major Degree earned Date entered mo/yr Last attended mo/yr.<br />
6. ______________________________________________________________________________________________________________________<br />
School name City State (or province & country)<br />
__________________________________________________________________________ /_________________________________/________<br />
Subject/major Degree earned Date entered mo/yr Last attended mo/yr.<br />
If you have attended additional schools, please include them on a separate sheet.<br />
International Applicants<br />
Any applicant who is not a citizen or a permanent resident of the US, is required to submit additional documents in order <strong>for</strong><br />
<strong>Rivier</strong> <strong>University</strong> to complete an I-20 document <strong>for</strong> your F-1 Student Visa application. These include a Letter of Financial Support<br />
and TOEFL/IELTS English language proficiency test scores. All <strong>for</strong>eign transcripts must be evaluated by an approved evaluation<br />
agency and submitted to <strong>Rivier</strong> <strong>University</strong>. Detailed requirements <strong>for</strong> these items are available at www.rivier.edu.<br />
Office of Graduate <strong>Admission</strong>s, <strong>Rivier</strong> <strong>University</strong> • 420 South Main Street , Nashua, NH 03060-5086
Graduate Record Exam (GRE)<br />
Applicants are required to provide scores from the following four GRE tests taken within the last five years <strong>for</strong><br />
1) Verbal Reasoning, 2) Quantitative Reasoning, 3) Analytic Writing, and 4) the Psychology subject test.<br />
Test details are available at http://www.ets.org/gre<br />
I have taken the GRE already: Yes No Date Taken: _____________/__________<br />
mo/yr<br />
I plan to take the GRE on: _____________/__________<br />
mo/yr<br />
Recommendations<br />
________________________________________________________________________________________________________________________<br />
Name<br />
Title<br />
________________________________________________________________________________________________________________________<br />
Relationship to applicant<br />
Email address<br />
________________________________________________________________________________________________________________________<br />
Name<br />
Title<br />
________________________________________________________________________________________________________________________<br />
Relationship to applicant<br />
Email address<br />
________________________________________________________________________________________________________________________<br />
Name<br />
Title<br />
________________________________________________________________________________________________________________________<br />
Relationship to applicant<br />
Email address<br />
<strong>Application</strong> Fee<br />
Please include a check payable to <strong>Rivier</strong> <strong>University</strong> <strong>for</strong> $100 with this application.<br />
My signature below indicates that all in<strong>for</strong>mation on this application and other documents submitted as part of the application are factual, complete, is my own work, and<br />
is presented honestly. Withholding in<strong>for</strong>mation requested or giving false in<strong>for</strong>mation may make me ineligible <strong>for</strong> admission. I also understand that the documentation I<br />
submit becomes property of <strong>Rivier</strong> <strong>University</strong> and will not be returned.<br />
Applicant’s signature<br />
Date<br />
In compliance with federal Clery Act legislation, <strong>Rivier</strong> <strong>University</strong> makes the Annual Security and Fire Safety Report available online at www.rivier.edu/ps.<br />
The Office of Graduate <strong>Admission</strong>s, <strong>Rivier</strong> <strong>University</strong>, 420 South Main Street, Nashua, NH 03060-5086<br />
Phone: (603) 897-8219 | psyd@rivier.edu | www.rivier.edu/admissions/graduate<br />
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