Admissions Interview

Required *

Name of of Applicant *

Address *

Contact numbers *

Your email *

Interviewer Name *

Interview Date

How did they hear about NJI: *

Interest in Psychoanalytic training: *

Educational background: *

Employment History: *

Current employment: *

Clinical experience: *

Personal Analysis: *

Program of interest: *

Part time or full time? : *

Requirements of program explained: *

Semester of interest/Classes begin: *

Received class schedule, course descriptions and explanation of PACO membership *
YesNo

Low fee supervision list given (optional for 1 yr program) *
YesNo

Registration instructions given: (mail in copy and/or how to register online – www.njinstitute.com,, under Registration tab, Courses) *
YesNo

Fall Semester Tuition: $350.00 per class plus $115 semester registration fee that includes PEP WEB library (for one year - paid in the FALL) and PACO membership (for one year -paid in the FALL)

Spring Semester Tuition: (for returning candidates) $350.00 per class plus $85 semester register fee that includes the graduation luncheon held in May.

Spring Semester Tuition: (for New candidates) $350.00 per class plus $155.00 semester fees that included PEP Web library, PACO membership and graduation luncheon held in May.

Tuition is due before class begins.(Fall semester by Sept. 1st; Spring semester by Feb. 1st)

If you need a monthly payment program, contact Jan Alderisio at jana6@optonline.net)

Refund policy: Half of the tuition will be refunded if less than four classes are taken. After four classes, there will be no refund; credit will remain on the account until candidate returns to the Institute.

The Candidate is in agreement with the above information. The Candidate understands that a requirement of admission is to submit an original graduate transcript, either electronically or by mail. A copy of your resume and credential(s) are also needed. The Candidate will be notified by mail of their acceptance to NJI for Training in Psychoanalysis and we will provide a candidate handbook at the time.

Candidate signature: *

Interviewer signature: *

Date: *

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