Name: ___________________________________ Date:________________

Home Address: _________________________________________________

Home phone #:____________________ Work phone #: _________________

Employer name/address: ___________________________________________
______________________________________________________________

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1. What prompted your interest in the SCSU Marriage and Family Therapy Program?













2. What background, knowledge, experiences, do you have with family therapy?













3. With which model(s) of family therapy are you familiar?













4. Write a brief statement about your goals once you have completed training. Bespecific.













5. In what therapeutic experiences have you participated?













6. What do you expect from the program? How do you expect to enhance the program?













7. Give three reasons why it might be better if you did not pursue this course of study and profession?













8. What might you have to unlearn to become an effective marriage and family therapist?













9. What relationships traditionally are difficult for you?

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