INSTITUTE OF GLOBAL EDUCATION
Special NGO consultant to the United Nations Economic and Social Council
DEPARTMENT OF INTEGRATED ECOLOGY
Michael J.Cohen, Ed.D. Director
INSTITUTE OF GLOBAL EDUCATION
Special
NGO consultant to the United Nations Economic and Social Council
DEPARTMENT OF
INTEGRATED ECOLOGY
Michael J.Cohen,
Ed.D. Director
Graduate Student Cooperative
Program
Applied Ecopsychology
Dr. Michael J. Cohen, Director
P. O. Box 1605,
Friday Harbor, WA 98250
888-285-4694 (toll free)
360-378-6313
www.ecopsych.com
nature@pacificrim.net
Affiliated University Degree Program Application Form
Application Instructions:
1. COMPLETE THIS APPLICATION and the IGE GRADUATE STUDENT COOPERATIVE CONTRACT that accompanies it (in another email.)
2. MAKE A HARD COPY OF THE APPLICATION AND POSTAL MAIL IT WITH YOUR ADMISSION FEE CHECK OR MONEY ORDER TO THE ADDRESS BELOW.
3. EMAIL THIS COMPLETED ADMISSION APPLICATION and the IGE GRADUATE STUDENT COOPERATIVE CONTRACT TO: nature@pacificrim.net
Affiliated University and IGE Graduate Student Cooperative Application for Admission
This application leaves things quite open-ended and we invite
you to communicate with us in a
manner that makes the most sense to you yet allows us to learn
as much
about you as possible so we may properly evaluate your application.
Name of Affiliated University_______________________________________________
( ) Institute of Global Education Certificate only
Please type or print clearly.
Name: _________________________________________________________________
FIRST MIDDLE/INITIAL LAST
Address: _______________________________________________________________
City: ____________________ State:______________Zip/Postal Code: _____________
Country:_________________________________ Date of Birth: ___________________
Telephone numbers: (include international access code):
Home: ___________________________ Work: ________________________________
Fax: _____________________________ Email: ________________________________
When is the best time to reach you: AM or PM by
Phone or Fax or Email
Degrees held: ___________________________________________________________
______________________________________________________________________
______________________________________________________________________
Degree sought:
( ) Bachelors
( ) Masters
( ) Masters with Bachelor's Waiver
( ) Doctorate
( ) Doctorate with Master's Waiver
Field of Study With Emphasis in: Applied Ecopsychology/Integrated Ecology:
_________________________________________________________________
2
Now tell us about yourself (continue on a separate sheet of paper
if necessary). Tell us about your educational background since
completion of high school. Discuss your degrees completed,
further coursework, non-traditional and informal studies, and
continuing education seminars.
______________________________________________________________________
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Tell us about your occupation including how long you have worked
with your present employer, your advancements through the company,
what you do, skills required, and what you have learned from working
there.
______________________________________________________________________
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3
Where would you like to see yourself 10 years from now and how
will your degree help you:
______________________________________________________________________
______________________________________________________________________
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Tell us why you have chosen to pursue an Applied Ecopsychology/Integrated
Ecology degree at this time. Why have you applied to this affiliated
University program?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Use the check list on the back page to be sure that everything
necessary for your application
is included. Then, read and sign the following statement. Send
this form, along with the rest
of your application and a cheque for US$60. You may charge
it to your Visa Credit
Card by using the form and payment point at
Payment Form. Please
be sure to accompany all payments with the Payment
Form. It's
one of the email forms that you receive and save when you register.
(or you may copy and paste it in an email by selecting
here)
Thank you.
I have completed the application above as well as the accompanying IGE GRADUATE STUDENT COOPERATIVE CONTRACT. The information supplied on my application is true and accurate. I give permission for an affiliated University and the IGE Graduate Student Cooperative to verify and confirm any aspect of the information provided on this form and on supporting materials. All work submitted on this application my own, except where clearly stated to the contrary. I understand and accept that if at any time it is demonstrated that I have misrepresented myself or my work, I may be dismissed from the affiliated University and IGE Graduate Student Cooperative with no refund of fees paid, and any degree(s) awarded may be rescinded. I acknowledge that this application is void after six months unless it is extended with permission.
NOTE: It is only possible to send credit card payments via our paypal station
Signature: _____________________________ Date: ____________________________
4 APPLICATION CHECKLIST
Keep a copy of the application form for your own records.
Along with this application we will need:
____ A letter from you which provides us with information on your
proposed field of study and what (if anything) you have already
done in this field academically, professionally, as
a hobby, a volunteer, etc., and
____ If you are applying for a Masters or Doctorate, and already
have a Masters thesis or a
Doctoral dissertation topic in mind, or if you have already done
some work on such a
project, you should describe this in some detail, enclosing additional
materials as
necessary and appropriate.
____ A copy of all transcripts and other academic records as
specified on the application.
Photocopies of transcripts are acceptable for submission with
the application. However, when you enroll, we will require certified
transcripts submitted to us from the school where they were issued.
We may require that you obtain a credit evaluation from a recognized
agency.
____ At least 2 letters of reference from people who know you
well. If possible, at least one
should be from an employer or person familiar with your career
and one should be from
a person familiar with your academic performance.
____ A current resume or C.V.
OPTIONAL ITEMS
____ Any letters, additional sheets describing yourself, your
educational and career
experience, goals, etc., copies of things written (articles and
books, published or
unpublished) or otherwise created (audio/video tapes or illustrations).
Please do not
send any original irreplaceable documents. Send copies. Although
we try to be
very careful, we do not wish the responsibility of having rare
documents on hand.
____ I.D. size photograph. If you can make this a full face
photo, the face portion 1" wide and
1-1/2" tall, or a JPEG file, we can use this photo to issue
you a student I.D. card upon
enrollment. This card is useful to identify you as a student,
thus gaining student
discounts, access to university libraries as a visiting student
and often lower rates at
special events. If you would like to have an I.D. card, please
mention this at the time
of your enrollment.
____ Anything else that you think might be useful in helping
us to know you better, and to
understand your motivation in applying for admission to the Cooperative
and affiliated University.
Be sure to enclose application fee of US$60. This is not refundable.
If you wish
to charge this to a Visa, Master Card, Diners or American
Express card, using the form and paypal station at Payment Form.
Please be sure to accompany all payments
with the Payment Form.. The
application fee will allow your file to remain open for six months.
If you are accepted and do not enroll within that time, you must
reapply for admission or petition for an extension.
Please be sure to sign the application.