Dear applicant,

Thank you very much for your interest in the SCIM January 2020 Academic Session.  We feel strongly about the value of training with SCIM for involvement in DCI Programs.  This training can benefit you and others in all areas of life.  We look forward to your application, and getting to know you!

Please answer all questions as completely as possible.  Failure to provide complete information may result in problems or delays with your application.  The information on this form will be kept strictly confidential, except for approved internal use by SCIM staff, administrators, and health professionals.

Please complete this application in English only.

At the end of the form, you will be asked to pay a $30 non-refundable application processing fee.  Your successful online payment of the fee will complete your application process. 

NOTE: This application must be filled out personally by the individual applying for admission.
It is necessary for all applicants to have excellent skill in reading, writing and speaking in English.