Student Application: Psychoanalysis
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Hattie R. Rosenthal College of Psychoanalysis
of Heed University

Application for Evaluation/Admission

   

1-877-287-2456

SusanJak@heed.edu

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   First Name                                     Middle           Last Name        
    
   Home Address  
 
   City                                                  State                                             Zip  Code

Telephone:   Home                     Business                                E-mail Address    
  --                             
Social Security Number            Marital Status                        Number of Dependents
      U.S.     Other - Please specify:        Female
  Date of Birth                                    Citizenship     Male
(Please enter 4 digit year) 
Indicate the Degree For Which You Are Applying:
PhD     PsyD     Tuition: $10,500.

   

Educational Background - Include Psychoanalytic Institute Training

   School / Institution                                                  Degree / Certificate - Dates /Awards   

 

   

Employment History

   Employer / Address                                           Dates

 

   

Recommendations

       Name                                 Address/Phone                         Relationship

 

   

Explain, in the box below, why you wish to pursue
 the degree indicated above, and why you wish to attend 
Heed University / Hattie R. Rosenthal College of Psychoanalysis.  

Race, Creed, Color, Sex and National or Ethnic Origin have no bearing on admission or other University administered programs. 
By submitting this form I certify that all information on this application is true and accurate to the best of my knowledge.

The following items must be received at the address below 
before Application for Evaluation/Admission will be processed:

Application fee of $45
Resume
Official Transcripts of all prior studies sent directly to 
Hattie R. Rosenthal College of Psychoanalysis of Heed University 
from the institution involved. 
Three letters of recommendation sent directly to Heed University 
from the institution or person involved. 
(Unofficial copies will be accepted for preliminary evaluation only.)

Please submit all application material to

Dr. Susan Jakubowicz, Director, 
Hattie R. Rosenthal College of Psychoanalysis of Heed University
PMB 288, 3900 W. Brown Deer Road, Milwaukee, Wisconsin 53209
1-877-287-2456     SusanJak@heed.edu

Heed University admits students of any race,
color, national and ethnic origin to all the rights, privileges,
programs, and activities generally accorded or made available to
students at the school. It does not discriminate on the basis of
race, color, national and ethnic origin in administration of its
educational policies, admissions policies, scholarship and loan
programs, and athletic and other school-administered programs.