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International Student Psychotherapy Program Application
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* Indicates required question
Name
*
Your answer
Gender
*
male
female
Student ID
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
major
*
Your answer
Grade/semester
*
Your answer
Email address
*
Your answer
modile number
*
Your answer
topics for psychological counseling
*
personality problem
interpersonal relationships
depression
anxiety
famliy conflict
career issue
academic problem
substance abuse issue
Other:
Required
application pathway
*
voluntarily
after viewing the notice (online/poster)
at the suggestion of the professor/counselor
at the urging of friends/peers/seniors
Other:
Selecting a language for your consultation
*
English
中文
한국어
requested counseling appointment time
Monday
Tuesday
Wednesday
Thursday
Friday
09:00
10:00
11:00
13:00
14:00
15:00
16:00
17:00
Monday
Tuesday
Wednesday
Thursday
Friday
09:00
10:00
11:00
13:00
14:00
15:00
16:00
17:00
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