First Name

Last Name

Preferred Pronoun

Age

Email

Cell Number

City

Address

Have you done the FECAT Program? Have you done the FECAT Program? Yes No

Year of Graduating the FECAT Program

Details of your Training in Creative or Expressive Arts Therapy

Details of your Experience in Creative or Expressive Arts Therapy

Are you presently in Personal Therapy? Are you presently in Personal Therapy? Yes No

Name of your Therapist

Are you currently seeing clients in any form of therapeutic settings? Are you currently seeing clients in any form of therapeutic settings? Yes No

Details of your Professional Practice

Are you presently in Supervision? Are you presently in Supervision? Yes No

Name of your Supervisor

Admission Category Admission Category General SC / ST / OBC LGBTQIA+

Statement of Purpose (limit to 500 words)

How did you hear about the Course

Declaration Declaration I declare that the information provided above is accurate and true to my knowledge. I understand that in case there are discrepancies found, SMArT reserves the right to terminate my application during the interview and assessment stage or post-admission, during the course of the program. I also understand and acknowledge that the fees are non-transferable and cannot be rolled over to the next year. I acknowledge that I have read and agree to the Refund / Withdrawal Policy stated below.