Application Form: Certificate in Narrative Focused Trauma Care Level I

Notes

Application Form 2019-2020

2019-06-04 GL Cloned from Application Form

2019-10-08 GL Removed RLP Scholarship description text box and changed the RLP tuition scholarship tiers (added $4000) and removed final tuition tier description. Changed the Start date from the Campaign start date to the Event start date.

2019-12-18 GL Added 255 character limit to Community Engagement Website field.

2020-01-22 GL Added 255 character limit to Career Field and

When testing using Selenium is complete, do the following:

Make the Photo required
Add the contextual help back to Birthdate (MM/DD/YYYY) and change back to date
Add Format back to College Attendance Date (##/#### - ##/####)
Add the Custom Format back to Preferred Phone Number ((###) ###-####)

Updates - Need to update the following annually

1. Edit Upcoming Group Interview Dates in the Interview and Preview block

2. Edit Upcoming Preview Dates in the Interview and Preview block

3. Edit Academic Terms in the Community Audit block

4. Edit the RLP Tuition Tiers in the RLP Scholarship block

Parameters - Should not require updates unless different records are created

SalesForce Prefill - Do not change

Campaign ID

Start Date

Include Graduate Application Block?

YesNo

Include Concentration Block?

YesNo

Include Community Audit Block?

YesNo

Non-Degree Flag?

YesNo

RLP Flag?

YesNo

RFPT Flag?

YesNo

Include Training Certificate I Block?

YesNo

Include Training Certificate II Block?

YesNo

Include Externship Block?

YesNo

Include Recovery Week Block?

YesNo

Include Story Workshop Block?

YesNo

Include Seattle School Influence Block?

YesNo

Include Allender Center Influence Block?

YesNo

Include Contact Information Block?

YesNo

Include Address Block?

YesNo

Include Photo Block?

YesNo

Include Demographics Block?

YesNo

Include Citizenship Block?

YesNo

Include Academic Background Block?

YesNo

Include Transfer Credit Block?

YesNo

Include Licensure Block?

YesNo

Include Ordination Block?

YesNo

Include Community Engagement Block?

YesNo

Include 1st Recommendation Block?

YesNo

Include 2nd Recommendation Block?

YesNo

Include Interview and Preview Block?

YesNo

Include Seattle School Compliance Block?

YesNo

Include Allender Center Compliance Block?

YesNo

Include Allender Center Scholarship Block?

YesNo

Include RLP Scholarship Block?

YesNo

Include Confirmation Block?

YesNo

Include Payment Block?

YesNo

Campaign Name

Academic Term

Second Academic Term

Third Academic Term

Application Fee amount

Application Fee GL Code

Total amount

Promo Codes

Interview Campaign 1

Interview Campaign 2

Interview Campaign 3

Interview Campaign 4

Interview Campaign 5

Preview Campaign 1

Preview Campaign 2

Facilitator List

Calculations - Do not change

Actual Charge (see Properties => Custom Code for actual calculation)

Please note that there is a significant amount of javascript associated with this form. It should not require any changes unless the promo codes change (and they should probably be moved out here). See Properties => Custom Code from the menu at the top of the page. Please note that the only way to find the section ID to hide and display the payment section is to read the page source.

Testing

Test Plans:

1. Create an application with each of the different interview dates and make sure the person is assigned to the correct campaign in SalesForce

2. Create an application with each of the different preview dates and make sure the person is assign to the correct campaign in SalesForce

3. Check the application for completeness

4. Check that all the application documents are present and accounted for

5. Check that all of the promo codes work.

6. Check that the correct charge is made in auth,net (and then have Accounting cancel it)

First Name

Middle Name

Last Name

Maiden/Former Name

Or any other names you may have used

Name you prefer to go by

Which program are you applying to?

Which track are you applying for:

Do you wish to apply for a concentration?

Have you previously applied to or attended The Seattle School of Theology and Psychology?

NoAppliedAttended

Please describe:

Are you the first in your family to attend graduate school?

YesNo

Please list other graduate school(s) and program(s) of study you are applying to

For which concentration do you wish to be considered?

Why are you pursuing studies at The Seattle School?

Are you a Seattle School alum?

YesNo

Do you want to use your alumni audit voucher?

YesNo

Have you previously attended The Seattle School of Theology & Psychology?

AppliedAttendedNo

In what academic term do you wish to study?

For which course(s) do you wish to be considered?

Do you have plans to enroll as a degree-seeking student at The Seattle School in the future?

YesNo

Are you applying for the Clinical Track? (To be eligible to apply for the Clinical track you must have an advanced degree (master’s level or higher) and work professionally as a counselor, therapist, psychologist, or social worker.)

Please briefly describe the work you do with people and what you hope to gain from this training.

How have you engaged your own story and grown to understand the way it impacts your life, relationships, and calling?

What experience have you had participating in a group? What did you learn about your presence or the role you tend to play? Where did you thrive and how did you struggle? If you have experience leading or facilitating groups, we’d love to hear more about that, too.

How do you engage difference (age, race/ethnicity, gender, class, perspective) in the context of relationship? What comes up for you? What are growth areas you are aware of?

Share a bit about your experience in Level I. What were your biggest takeaways? How have you continued to grow in your own story?

What did you learn about yourself in the context of the small group experience in Level I? What blessed you? What challenged you?

Tell us about the context in which you are currently serving people. How are you applying what you learned in Level I to your work?

What do you hope to gain in Level II? How do you wish to grow? What are your long term goals?

Please select the program(s) you have completed as a prerequisite to apply to the Externship Program:

Seattle School graduateAllender Center Training Certificate Level II recipient

What is drawing you to participate?

How does narrative, the nuance of harm, faith, and redemption inform your theory of change?

What do you hope to gain in your professional or clinical development through this program?

Please describe work you have done to engage your story of abuse, or share more about why you have not yet engaged.

Please describe your current support structure. For instance, are you doing individual work with a professional or pastoral counselor? Are you doing group work with a recovery ministry?

What is drawing you to participate?

What experiences have you already had engaging your story?

What kind of involvement have you had in small groups?

How would you describe your current support system?

How and when did you first hear about The Seattle School of Theology & Psychology?

Who or what influenced you to apply?

Teacher or ProfessorCounselor or TherapistPastor or MinisterFamily or FriendSeattle School FacultySeattle School AlumnusSeattle School Current StudentVisit to CampusThe Seattle School websitePrint Material or PublicationAdmissions RepresentativeParish CollectiveOther

How and when did you first hear about The Allender Center?

What previous Allender Center involvement have you had?

Effective Trauma CareStory WorkshopStory GroupsRecovery WeekIntimate MysteryTo Be ToldSabbath RetreatDesign of DesireHealing the Wounded HeartTraining CertificateOnline CourseBookOther

Who or what influenced you to apply?

Confirm Email

Email Type

Preferred Phone Number

Phone Type

What is your preferred method of communication?

Address

City

Country

State

Province

State/Province

Zip/Postal Code

Thank you for uploading a photo. This helps us put a face to your name as we move through the application process. We look forward to meeting you in person and would love to be able to welcome you by name!

Please limit file size to under 2MBs.

Date of Birth

Gender

Do you consider yourself to be Hispanic/Latino?

YesNo

Which of the following race group(s) do you consider yourself a part of?

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteSelect all that apply

Please describe your ethnic identity/heritage:

Which of the following best describes your relationship status?

Do you have a church affiliation?

What is your primary church affiliation?

Tell us of your church affiliation:

Which of the following best describes your occupational status?

What is your career field?

Are you a US citizen?

YesNo

Please explain your citizenship and national residency status:

Official transcripts are required from any post-secondary institutions you have been enrolled at for credit-bearing coursework. Please list these institutions and provide details related to your educational background in the fields below. It is your responsibility to contact your post-secondary institution(s) to request official transcripts.

Have you attended any post-secondary institutions?

YesNo

Institution Name:

Degree Pursued

Dates attended

Are you currently enrolled?

Did you graduate?

YesNo

GPA

The Seattle School accepts transfer credits from other graduate-level programs. Students may transfer a maximum of 15 semester credit hours toward their degree program at The Seattle School. Please refer to our Transfer Credit Policy for more information.

Have you completed any graduate level coursework?

YesNo

Do you intend to submit coursework for transfer credit?

YesNo

Please select the top three (3) areas in which the majority of your work takes place.

children	adolescents	adults
families	marriage	domestic violence
sexual trauma	grief	depression
anxiety	personality disorders	PTSD
stress	race/culture	faith
not in helping role

Are you licensed?

YesNo

Licensure Date

State of licensure

License number

Are you ordained?

YesNo

When were you ordained?

MM/DD/YYYY

As we consider your application we’d love to get a sense of your community engagement. These organizational affiliations may be professional, clinical, creative, independent (i.e. your business/private practice; blog or podcast you curate), or cultural (i.e. social advocacy group).

Organization name

This is my employer

Role/Title

Website

Organization Type

ChurchCompanyGovernment AgencyMedicalNon-profitSchool

Please provide us with reference names and email addresses. We will send them a link to a recommendation form that they can complete online.

As you select your references, consider women and men who can speak to your character, maturity, emotional intelligence, self-awareness, intellectual curiosity, and spiritual depth. Consider asking a pastor, mentor, professor, therapist, supervision/employer, or colleague. Please refrain from submitting references from family members, friends, or acquaintances.

Under the Family Education Right and Privacy Act of 1974 (Buckley Amendment), which gives the right to inspect and review their educational records, students may waive their right to see specific confidential letters or recommendations. In the belief that applicants and the persons from whom they request evaluations may wish to preserve the confidentiality of those evaluations, we are giving you an opportunity to select one of the following statements:

I waive my rights to examine recommendation forms submitted on my behalf.I do not waive my rights to examine this form, but authorize the person completing my recommendation to provide a candid evaluation.

Recommendation 1

First Name

Last Name

Phone

Relationship

Length of Relationship

Recommendation 2

First Name

Last Name

Phone

Relationship

Length of Relationship

At The Seattle School we place a high value on gaining a holistic experience of our applicants. Because we are intentional about creating an opportunity for each applicant to be seen and known our group interview process is a part of the application process.

The interview process is designed to give applicants a robust, in-person experience of our experiential and relational learning community and curriculum. Interviews include a small group component where applicants are divided into groups of 5-7 to engage in discourse facilitated by a member of our instructional staff.

Your application and supporting documents must be complete to participate in a group interview. Interviews are required for all applicants. Please register for an interview date below.

Approval for an individual or distance interview on an alternate date in extenuating circumstances. If this applies to you, please provide us context in the fields below.

Upcoming Group Interview Dates

Please describe your circumstances.

Interview dates marked with an asterisk denote an interview scheduled the Monday following a Preview event. Our Preview events are a great way to gain a robust experience and understanding of The Seattle School. There is no cost to attend and you’re welcome to bring family or friends. We’d love to have you. Learn more at theseattleschool.edu/admissions/.

Upcoming Preview Dates

Please let us know if you have any dietary restrictions so that we can accommodate your needs.

Dietary restrictions

We seek to set a table for discourse in the intersections of theology, psychology, culture, and spirituality. That means we embrace in our life and work a commitment to racial, ethnic, and gender diversity and an inclusive welcome to communions represented in the global church. Our admissions philosophy is to receive applications without discrimination on the basis of race, ethnicity, religion, gender, age, national origin, disability, marital status, sexual identity, sexual orientation, military status, or denomination.

Have you ever been suspended or expelled from an academic institution?

YesNo

Please provide a brief description of the circumstance(s).

Have you ever required psychiatric or psychological treatment?

YesNo

Please provide a brief description of your treatment.

The intent behind this question is to gather information about significant psychiatric or psychological treatment (e.g. recent experience or memory of intense trauma, onset of PTSD, hospitalization, suicide attempts, in-patient rehab). As a community we encourage and honor personal therapeutic work and do not discriminate against individuals who have sought help. If your answer to this question is “yes”, we’d like to gain a greater understanding of where you are at in your own process in order to decide together whether or not this program would be safe and honoring for you at this time.

Do you have charges pending against you, entered a plea for, or been convicted for a crime other than a minor traffic violation?

YesNo

Please provide a brief description of the charges and/or crime.

A limited number of scholarships are available for those experiencing financial hardship or for applicants from under-represented racial or ethnic communities.

I'd like to apply for a scholarship

Please describe your financial circumstances and how a scholarship would make this program accessible to you. Please share other financial support you have access to (i.e. professional development funds, organizational partnerships, church support).

Amount requested

I am a member of an under-represented racial or ethnic community.

What tuition tier are you applying for?

$4,000$3,000$2,000$1,000

Please type your full name, understanding that it is legally equivalent to your signature.

I submit that all the information contained in my application is complete and accurate. I understand that any falsification of information makes my application null.

Application Fee: $

promo code

Name on Card:

First Name

Last Name

Month

Year

Credit Card #

Security Code

Auth.net - DO NOT CHANGE

Authnet_Hidden_Fields

Contact Information