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Statement of Authenticity I do certify that all of the work contained in this portfolio is my own and that all quoted material is identified and cited as per the style of the American Psychological Association style (APA) publication manual. _______________________________ Name

_____________________ Date

_______________________________ Signature

Doctoral Intake Portfolio Application Agreement All Portfolio Applications submitted to the Department of Curriculum & Instruction will be retained by the department for a period of one year following the Doctoral Intake Process. The student may request return of her or his portfolio (in writing) and either pick it up or, pay for mailing expenses in advance. _______________________________ Name

_____________________ Date

_______________________________ Received by the Associate Department Head for Graduate Programs

_____________________ Date


Statement of Authenticity