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Application Form CBT FOHYLf3

This document is an application form for a one-year Postgraduate Diploma in Cognitive Behavior Therapy (CBT) at Gandhara University Peshawar. It requires personal details, contact information, educational background, supporting documents, and referees. Applicants must confirm the accuracy of their information and submit a non-refundable registration fee along with their application.

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Yasir Sultan
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12 views2 pages

Application Form CBT FOHYLf3

This document is an application form for a one-year Postgraduate Diploma in Cognitive Behavior Therapy (CBT) at Gandhara University Peshawar. It requires personal details, contact information, educational background, supporting documents, and referees. Applicants must confirm the accuracy of their information and submit a non-refundable registration fee along with their application.

Uploaded by

Yasir Sultan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Gandhara University Peshawar

Postgraduate Medical Sciences


Bashir Psychiatric hospital & Institute, 71 Abdara Road, University Town,
Peshawar, Pakistan. Tel: 0343-9010001, Website: www.bashirpsych.com

APPLICATION FORM
Paste you photo
One-year Postgraduate Diploma in Cognitive Behavior Therapy (CBT)

Please write in BLOCK CAPITALS. Complete ALL SECTIONS.

Section A: Your Personal Details

First Name: __________________Last Name: ________________


Father Name: ________________

Gender: Male Female

Section B: Contact Information

Corresponding Address: _______________________________________________

City ______________________ Province _________________________________

Telephone ____________
____ Mobile ___________________________________

Email Address ___________________

Section C: Details of Current and Previous Education

Title of Qualification Start Date Completion Date Grade Institution


Section D: Supporting Documents

Following Supporting documents is required with all Applications.

1. Attested copies of award certificates / qualifications


2. Attested copies of experiences certificates
3. Original bank draft/ transfer receipt of Rs 2000/- Registration fee Non-Refundable, Payable to
Postgraduate Clinical Studies. HBL Bank Account number 1967-79003265-01.
4. Two color passport size photographs.
5. A current Resume/ CV
6. Personal Statement (briefly describing why you wish to attend this course and how is it going to
benefit your current work).

Section E: Referees
Provide names and contacts of 2 referees

1. Name 2. Name
Designation Designation
Institution Institution
Email Email
Contact Contact
DECALARATION

I confirm that the information I have provided on this application form is to (to the best of my knowledge)
true, accurate, current, and complete; and I agree to notify the course organizers promptly if any
information contained on this application form should change. I confirm that all supporting work submitted
as part of this application is entirely my own original work, except where clearly stated otherwise, and
does not include any plagiarized elements.

Signature _______________ Full Name ______________________ Date: ______________________

Application Receive Date _______________


FOR OFFICE USE ONLY

Application Receive Date _______________

Accepted Rejected

Reason for rejecting application: ___________________________________________________

Signature of the Course Director: ___________________

Enrollment number: ___________________

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