MASTER OF CLINICAL PSYCHOLOGY
SUPPLEMENTARY APPLICATION FORM
This form must be completed and accompany your application for:
Master of Clinical Psychology.
Applications via UAC - UAC course code:
882710 – Master of Clinical Psychology
1
Go to www.uac.edu.au (Universities Admissions Centre) and complete your application online,
include your Curriculum Vitae with your application
2
Referee to complete the supplementary form, this can be uploaded with your UAC Application
online or the referee may email it separately to applications@canberra.edu.au
When you apply through UAC you must upload your supplementary form and CV as a pdf (portable
document file). You can convert to pdf by emailing your document to conv2pdf@uac.edu.au. Go to
http://www.uac.edu.au/ for further details.
Direct Applications via the University of Canberra Online Portal - University course codes:
742AA – Master of Clinical Psychology
1
Go to http://www.canberra.edu.au/apply-now and complete your application online.
2
Complete the supplementary form and include this form and your CV with your Online Application
or the referee may email it separately applications@canberra.edu.au
Personal Details
Name
Date of Birth
UAC Application number / UC student ID / Online Portal Application number
Applicant to submit:
1) An application via UAC (University Admissions Centre) or Direct via the Online Portal
2) Two Referee Reports
Admissions Office
Student Administration
P: 1300 301 727
F: +61(0) 2 6201 5040
E: admissions@canberra.edu.au
W:www.canberra.edu.au
Australian Government Higher Education Registered Provider
Number:
University of Canberra (CRICOS) # 00212K
University of Canberra College (CRICOS) # 01893E.
Postal Address:
University of Canberra ACT 2601 Australia
Location:
University Drive, Bruce ACT, Australia
MASTER OF CLINICAL PSYCHOLOGY
SUPPLEMENTARY APPLICATION FORM
Proforma for references (confidential)
To be completed by referee
Applicants for the Master of Clinical Psychology have been requested to distribute these forms to
referees. You may choose to use this form or have the option to write a separate written reference.
Referees are asked to comment on the applicant’s character, interpersonal skills, management skills,
work ethic and suitability for PG study (by coursework).
Referee to complete the questionnaire below:
Name of referee
Contact details (email)
Position
Department
Subject(s) taught
Name of student applicant
Intended course
Master of Clinical Psychology
How long have you known the
applicant?
In what capacity
(lecturer,employer)?
Your evaluation of the applicant:
No basis for
judgement
Below average
Average
Better than average
Academic performance
Outstanding
Please tick the areas relevant to your position
Application to study
Participation in class
Verbal skills
Admissions Office
Student Administration
P: 1300 301 727
F: +61(0) 2 6201 5040
E: admissions@canberra.edu.au
W:www.canberra.edu.au
Australian Government Higher Education Registered Provider
Number:
University of Canberra (CRICOS) # 00212K
University of Canberra College (CRICOS) # 01893E.
Postal Address:
University of Canberra ACT 2601 Australia
Location:
University Drive, Bruce ACT, Australia
MASTER OF CLINICAL PSYCHOLOGY
SUPPLEMENTARY APPLICATION FORM
Written skills
Capacity for self-directed learning
Ability to work independently
Interpersonal skills
Ability to reason critically
Initiative
Ability to work as part of a team
Suitability for PG study
[Office use only]
General comments to be made below:
We are particularly interested in the applicant’s personal characteristics (professionalism, interpersonal skills
etc) and potential suitability for working as a health care professional.
.
.
[Office use only] ________________________________________________________________________________________________
Admissions Office
Student Administration
P: 1300 301 727
F: +61(0) 2 6201 5040
E: admissions@canberra.edu.au
W:www.canberra.edu.au
Australian Government Higher Education Registered Provider
Number:
University of Canberra (CRICOS) # 00212K
University of Canberra College (CRICOS) # 01893E.
Postal Address:
University of Canberra ACT 2601 Australia
Location:
University Drive, Bruce ACT, Australia