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The 2023 Level 2 PACT Institute Equity Scholarship

Application Instructions For the scholarship application, you will be asked to submit EITHER a

School transcript, if you are currently in school or graduated within the last 3 years

Resume or CV, if you graduated more than 3 years ago

IN ADDITION, you will be asked to submit a letter of recommendation written by a:

Teacher or supervisor, if you are currently in school or graduated within the last 3 years 

Peer clinician or a teacher/supervisor, if you graduated more than 3 years ago 

The letter of recommendation should include: 

Contact information of the person writing the letter

How long they have known the applicant 

In what capacity they have known the applicant

Reasons why they recommend the applicant for PACT training, including any specific examples or insights they have about how the applicant works with couples or individuals. 

Application. Please have these documents ready before beginning your application. You will NOT be able to save your application and return to it later. 

Submission. All documents must be included in the application submitted via the website. Documents submitted via email will NOT be accepted.

File format. We accept the following file formats for document uploads: Microsoft Word, PDF, JPEG or PNG. Applications using other formats will NOT be accepted.

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Question 1 of 18

Name:

Question 2 of 18

Email: 

Question 3 of 18

Location (City, State, Zip Code OR City, Country if not in the US)

Question 4 of 18

Degree (earned or expected) and year(s):

Question 5 of 18

Graduate school you are attending or attended:

Question 6 of 18

If you are currently in school or graduated within the last 3 years, please attach your most recent transcript. If you graduated more than 3 years ago, please attach a resume or CV.

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Question 7 of 18

If you are currently in school or graduated within the last 3 years, please attach a letter of recommendation from a teacher or supervisor. If you graduated more than 3 years ago, please attach a letter of recommendation from a peer clinician or a teacher/supervisor. The letter should include contact information of the person writing the letter, how long they have known the applicant, in what capacity they have known the applicant and reasons why they recommend the applicant for PACT training.

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Question 8 of 18

Employer or Supervisor Name & Contact Information:

Question 9 of 18

How long have you been in practice as a therapist?

Question 10 of 18

Do you see couples? 

If so, approximately what percentage of your practice is couples?

Question 11 of 18

When did you complete PACT Level 1 training? 

Question 12 of 18

What are your career goals?  (Please describe in about 100 words.)

Question 13 of 18

Why do you want to take PACT training? (Please describe in about 100 words.)

Question 14 of 18

How did you find out about this scholarship?

Question 15 of 18

Which of the following best describes you? Select all that apply. 

(Select all that apply)
A

Asian

B

Black or African American

C

Hispanic or Latinx

D

Native American or Alaskan Native

E

Native Hawaiian or Other Pacific Islander

F

White or Caucasian

G

A race/ethnicity not listed here

H

Prefer Not to Answer

Question 16 of 18

Which PACT training do you plan to enroll in?
Each cohort is for a different date and time, please check the website for the most appropriate time for you. If you check "Either cohort" and are selected, the scholarship selection committee will offer you a scholarship that is for one cohort of their choosing which is nontransferable to another cohort.

A

Level 2, Cohort 1 (7am - 12:30pm Pacific Time)

B

Level 1, Cohort 2 (2pm - 7:30pm Pacific Time)

C

Level 1, Either Cohort (if you have a preference, do not select this

Question 17 of 18

What lived experience makes you a candidate to receive an equity scholarship?

Question 18 of 18

Please describe the communities you serve: 

Confirm and Submit