PCIT Application

Full Name*


EFL Site Attended

Student Administrator

College/University Currently Attending

Home Address

Home City

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Home Phone Number

Cell Phone Number

Email Address*

School Address

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School State

School Zip

School Phone Number

Which address is best to send correspondence to?

Date One

Date Two

Essay: Write what you consider to be a thorough job description for an ideal PC. Why are you a qualified candidate for this PC job?

1. Why are you interested in being a PC-In-Training? If appropriate, please share a specific experience from the program you attended that influenced you to apply.

2. If you could only use 3 adjectives to describe yourself, what 3 would you choose? Why?

3. Based on the PC expectations and demands you've identified, what do you predict will be the biggest challenge for you?