2024 YSRSP Application Form

York-Seneca Rehabilitation Services Certificate Program application form 2024

1. Name 1. Name * First Last
2. Enter Student Number *
3. Email (provide your @yorku.ca email): *
4. Phone (Home)
5. Phone (cell)
6. Address 6. Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
7. Department of Studies (e.g. Psychology, Kinesiology, etc.) *
8. Degree Program (Hons BA/BSc, BA) *
9. Student status (Full time/ Part time) *

9. Student status (Full time/ Part time) Full Time Part Time
10. What year are you currently in *

10. What year are you currently in First Year Second Year Third Year Fourth year
11. Number of credits estimated to be completed by the time of application: *
12. Do you provide us with consent to review your York U academic transcript to screen for requirements? *

12. Do you provide us with consent to review your York U academic transcript to screen for requirements? Yes No
13. Upload an up-to-date Resume/CV that your work history, relevant volunteer experience, as well as professional and career goals related to rehabilitation. *

Attach Files
14. List two individuals who know you well and are willing to provide an evaluation of your potential for study and work in the field of rehabilitation. These persons may be contacted as part of the admission process.
Your referees could be a current or former: employer, professor, religious leader, volunteer supervisor, teacher, TA, etc. It is preferable to select referees who have had an opportunity to observe you in activities that are relevant to the field of rehabilitation.

First Referee
Provide Name, Position, Organization, Telephone, E-mail.
Second Referee
Provide Name, Position, Organization, Telephone, E-mail.
15. Would you like to be considered for a one-time entrance scholarship offered through a donation from Wawanesa? (Requires separate application) *

15. Would you like to be considered for a one-time entrance scholarship offered through a donation from Wawanesa? (Requires separate application) Yes NO
16. I confirm that I meet the following admission requirements:
1. Completed 60 credits towards a B.A./B.Sc. degree OR completed 90 credits towards an Honours B.A./B.Sc. degree.
2. Completed Introduction to Psychology (HH/PSYC 1010 6.0) and other General Education requirements of York University.
3. Be in good academic and financial standing with York University.
4. Minimum overall GPA of 5.0 or C+ (equivalent to 2.5 on a 4.0 scale/~65-69%).
Previous work or volunteer experience in the field of rehabilitation is recommended but not required. *

16. I confirm that I meet the following admission requirements:
1. Completed 60 credits towards a B.A./B.Sc. degree OR completed 90 credits towards an Honours B.A./B.Sc. degree.
2. Completed Introduction to Psychology (HH/PSYC 1010 6.0) and other General Education requirements of York University.
3. Be in good academic and financial standing with York University.
4. Minimum overall GPA of 5.0 or C+ (equivalent to 2.5 on a 4.0 scale/~65-69%).
Previous work or volunteer experience in the field of rehabilitation is recommended but not required. Yes No
17. OPTIONAL:
How did you hear about the YSR program?