South American International University

Programme Selection

This application is for admission to the following programme

Doctorate in Alternative Therapy & Holistic Healing

Doctorate in Art Therapy

General Information

Last Name

First Name

Middle Initial

Passport Number

Aadhar Number

Sex

Male

Female

Other

Age

Date of Birth / Place of Birth

Citizenship

Current Mailing Address

City / State / Zip Code / Country (Current)

Phone/Mobile

Work Phone

Personal Information

1. Do you have physical handicaps?

Yes

No

2. Have you ever taken any prescription drugs for any medical or emotional illness or learning disorder?

Yes

No

3. Have you ever had a licence denied, suspended or revoked by any regulatory committee?

Yes

No

4. Have you ever been disciplined or dismissed by an academic or professional committee, or denied admissions by any professional organisation?

Yes

No

5. Have you ever been charged with or convicted of a felony?

Yes

No

Additional Information

9. How do you plan to finance your education at ASHA THE HOPE/SAIU?
Please indicate the percentage of support you anticipate in each category.

Loans

Family / Parental Support

Personal Savings

Other Sources

Eligibility

Masters degree (any stream) or Graduation with a minimum of 5 years of professional experience.

Highest Qualification

Field of Study / Specialisation

Institution Name

Year of Graduation

Employment History and Activities

1. Please list your employment history beginning with your current occupation.

Employment History

Job Title

Date of Employment

Place of Employment

2. Please list volunteer, college and extra-curricular activities in which you participated

3. Please list any therapeutic, counselling, healing or wellness-related experience

4. Do you have other interests, hobbies or pursuits?

Letter of Recommendation

One (1) letter of recommendation is required. Please upload them below.

Upload Letter of Recommendation (1 required)

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Personal Statement

Your Personal Statement is your opportunity to communicate to the Admissions Committee anything that you feel is important and may not be sufficiently covered by the standard application format. Please upload it below.

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Remarks

Declaration

I hereby declare that the information provided in this form is correct to the best of my knowledge and ability. I promise to abide by the rules of admission and I have read and understood these rules properly.

Note: Any false or misleading information supplied by an applicant will be grounds for withdrawing any acceptance issued or future dismissal from ASHA THE HOPE/SAIU.

Name of Candidate

Date

Place

Declaration

I confirm that the information provided is true and correct to the best of my knowledge