Kelowna College of Professional Counselling

Counselling Aptitude Assessment (CAA)
To Determine the Potential of the Applicant for Counsellor Training and Practice

Confidentiality
The purpose of this questionnaire is to explore relevant life experiences, strengths, motivation and goals possessed by applicants to the Kelowna College of Professional Counselling. The information provided by applicants will be kept strictly confidentioal. It is intended for use by the Registrar to help determine eligibility for admission and proficiency with the English language.

Instructions: Click CONTINUE at the bottom of each page to go on to the next. Please complete answers to all questions
then click SUBMIT on the final page. Contact Admissions Advising at (250) 717-0412 if you require assistance.

Payment: When you have successfully completed the CAA, you will be offered several ways to complete payment of the Application Fee ($60CDN for Canadian students/$69CDN for all others). Click here to go to our payment page. (opens in a new window)
Your form will not be processed until we receive your payment.

Name::

Desired start date:(required)

Agreement: (required)

I understand that the CAA and an orientation meeting with the Registrar, either in person or by telephone, are required of all applicants seeking admission to the Kelowna College of Professional Counselling.

Check all that apply:

Diploma of Applied Psychology and Counselling (one year)

Certificate of Applied Counselling Studies (seven months in specialized area of study)

On Campus study

Distance Education

Combination of on-campus classes and Distance Education courses.

CAA Continued: Page 3
General Information

Age:		18-25 26-35 36-50 51-65 over 65

Gender:		Male Female

CAA continued: page 2
Personal Information

Today's Date:
Address:		City:
Province:		Postal Code:
Country:
Home Phone:		Work Phone:
	Note: If you are an INTERNATIONAL APPLICANT, please include telephone routing and country codes.
Fax:		E-mail:
Canadian Social Insurance Number: (answer n/a if not applicable)

Emergency Contact
Name:		Phone:

CAA Continued: Page 4
Career Goals and Motivation

What practical skills and/or natural abilities do you possess which you feel will enhance your effectiveness as a counsellor?
What characteristics do you possess that might inhibit your ability to be an effective counsellor?
Why did you decide to begin training to become a counsellor at this point in your life?
Do family and friends support your decision to become a counsellor? Why or why not?

CAA Continued: Page 5
Employment Goals and Job History

What type of counselling positions or areas of specialization do you intend to pursue?

List any job skills or experiences you have acquired in your history of employment which apply to the practice of counselling.

CAA Continued: Page 9
Miscellaneous Information

How do you intend to fund your education? Please specify-personal savings, student loans, etc.
Have you filed for bankruptcy, or been convicted of a crime for which a pardon has not been granted ? If yes, please explain.			Yes No

How did you find Kelowna College of Professional Counselling?
(optional)

CAA Continued: Page 7

Education (cont.)

Have you ever taken a correspondence course or enrolled in a Distance Education program? If "Yes", what was the outcome?

Do you experience any difficulties in structured learning environments? If yes, please explain.

How do you rate your written skills at this point? Please comment.

How do you rate your reading skills at this point? Please comment.

Do you have confidence in your ability to complete assignments?

Yes

No

Do you have confidence in your ability to participate in class discussions?

Yes

No

Are you willing to examine your feelings and beliefs in an attempt to increase your self-awareness?

Yes

No

CAA Continued: Page 8
Physical/Medical/Mental Conditions

Do you have any medical information or a medical or psychiatric condition/disability, you wish to be taken into consideration that may interfere with your ability to function as a student? If yes, please explain.

I am requesting accommodations related to the above identified disability that has been documented by a recognized professional. (Please provide the name of the documenting medical professional).
If yes, please submit by mail the required documentation to support your requirement for reasonable accommodations.

CAA Continued: Page 6
Education

Educational History:
List any degrees diplomas or educational programs and describe their relevance to future employment as a counsellor.

	Place	Date	Description

University Degrees:



High School:

Certificates:

Other Educational Programs:

CAA Continued: Page 10

Miscellaneous Questions (contd)

List one personal reference who supports your decision to enroll in the counsellor training program.

Name: Address: Phone:
Note: If your Reference Address is the same as your personal address, please change it in some way, i.e. if you abbreviated St. in one, spell out Street in the other.

My relationship to the reference is:

	Professional i.e. doctor, lawyer, clergyman
	Type of profession
	Colleague
	Other
	Type of reference

Signature: (enter your full name) Date:

Check to make sure you have answered all questions before you press the SUBMIT button.

If you do not receive confirmation of the submission of your online application within 7 days, please advise the admissions department at studentadvisor@counsellortraining.com, or contact Admissions Advising at (250) 717-0412

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Remember to Pay Your Fee.
When you have successfully submitted your CAA you will be offered 3 ways to pay your fee. Please choose one and make your payment immediately. We will not process your application until we recieve your payment



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