CFPS Application

CFPS Application

Application deadline for the Adult Programs - March 1, 2026.

Application deadline for the Child Programs - July 1, 2025.

Classes for the Studies in Adult Psychoanalysis and

Adult Psychodynamic Psychotherapy

will begin Fall of 2026.

Studies in Child Psychoanalysis/Studies in Psychodynamic Psychotherapy Classes -Yearly Rolling Admissions.

Submission Date*

PERSONAL INFORMATION

First Name*

Middle Name or Initial

Last Name*

Degree*

Select

E-mail*

Cell Phone

Birth Date

Application for:

Child Psychoanalytic Psychotherapy

Studies in Adult Psychoanalysis

Studies in Adult Psychodynamic Psychotherapy

Studies in Child Psychoanalysis

Studies in Child Psychoanalytic Psychotherapy

Studies in Adult Psychoanalytic Thinking

Studies in Child Psychoanalytic Thinking

Adult TA/SA

License Type and Number

Are you a Physician?*

Yes

Employment/ Workplace

Office Phone

Street Address

City

Select or enter value

State / Province

Select or enter value

Zip Code

Home Street Address*

Home City*

Select or enter value

Home State*

Select or enter value

Home Zip Code*

EDUCATION

Undergraduate College & Address

Undergraduate Major Areas & Degrees

Undergraduate Dates

Additional - Undergraduate College & Address

Additional - Undergraduate Major Area & Degrees

Additional - Undergraduate Dates

Graduate College & Address

Graduate Major Area & Degrees

Graduate Dates

Additional - Graduate College & Address

Additional - Graduate Major Area & Degrees

Additional - Graduate Dates

CLINICAL TRAINING

Organization

Nature of Service

Dates Served

Organization

Nature of Service

Dates Served

Organization

Nature of Service

Dates Served

Organization

Nature of Service

Dates Served

CLINICAL (INCLUDING PRIVATE PRACTICE)

Organization

Service

Dates

Organization

Service

Dates

Organization

Service

Dates

Organization

Service

Dates

Organization

Service

Dates

ACADEMIC APPOINTMENTS

Organization

Position

Dates

Organization

Position

Dates

Organization

Position

Dates

Organization

Postion

Dates

Organization

Position

Dates

ADDITIONAL EMPLOYMENT HISTORY

Organization

Nature of Service

Dates

Organization

Nature of Service

Dates

PROFESSIONAL MEMBERSHIPS

Organization

Dates

Organization

Dates

Organization

Dates

Organization

Dates

Organization

Dates

Organization

Dates

Organization

Dates

SCIENTIFIC PUBLICATIONS

Publication

PREVIOUS PSYCHOANALYTIC TRAINING

Institute & Address

Academic Years Completed

Dates

Institute and Address

Academic Years Completed

Dates

PERSONAL PSYCHOTHERAPY OR PSYCHOANALYSIS

Therapist Name

Dates

Address

Therapist Name

Dates

Address

Therapist Name

Dates

Address

REFERENCES

Please include one reference from a CFPS Community Member - such as Faculty, Candidate, Trainee or Alumni of one of the programs.

Name

Dates Known

Email Address

Name

Dates Known

Email Address

Name

Dates Known

Email Address

ADDITIONAL DETAILS

1. Have you ever been involved in or threatened legal action related to your work or have any malpractice claims or suits filed against you by clients/patients or colleagues?*

Select

2. Have you ever been denied or suspended from an appointment at an academic or clinical institution?*

Select

3. Have you ever been denied by or suspended from any licensing agency?*

Select

4. Have you ever been involved in an ethical charge in relation to your professional work?*

Select

5. Have you ever been convicted of a felony?*

Select

6. Do you have any physical or emotional condition that may adversely affect your ability to practice or participate in the coursework at CFPS?*

Select

If "Yes" to any of the above questions, please provide an explanation.

Please attach (upload the documents listed below.

The autobiography may be brief, 3-5 pages, and provide a sense of the important experiences and relationships in your life that have led you to seek training in psychodynamic psychotherapy.

Please submit the following documents in one of the two ways:*

Autobiography, Insurance, Transcripts, License Photo (Will be used in pictorial directory for instructors and other trainees), CV/Resume

Upload Now

File Attachments

Photo, Resume, Transcripts, Insurance, License...

Drag and drop files here or

My application is incomplete. Please email me a link to update my application at a later time.

Certification*

I certify that the above information is complete and correct. By signing this application for admission to The Center for Psychoanalytic Studies, I acknowledge that upon matriculation I am subject to the by-laws and policies of the Institute with respect to any activities that relate to my position as a trainee at the Institute. I acknowledge that I have access to a copy of the Center’s by-laws and policies that pertain to me and that I will be responsible for understanding and complying with them throughout the term of my training at the Institute. I hereby authorize The Center for Psychoanalytic Studies to contact the above-named references and institutions and authorize the above-named references and institutions to release information relevant to my application to Center for Psychoanalytic Studies. I understand that submission of this application is the beginning of the review process and does not constitute acceptance to any CFPS training program(s).

Select

Send me a copy of my responses

Privacy Notice|Report Abuse