ACT Program Application Form

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ACT Program Application Form

 
The application period for the 2026-2027 Cohort of the ACT Program will open November 1, 2025!
 

If you are interested in applying for the 2026-2027 Cohort of the ACT Program, please reference the Sample Application Form below. Note that there may be changes to the information requested.

SECTION BELOW FOR REFERENCE ONLY

Please read the information below before proceeding with the application:

  • Applications will be submitted via an Online Application Form.
  • Applicants will not be able to save the application in an incomplete form. We recommend that applicants use the ACT Program Sample Application Form to ensure that all application prompts are completed and documents for upload are ready prior to beginning the Online Application Form. Applicants are not able to Save Progress of applications once started. We apologize for the inconvenience.
  • The list of documents applicants will need to upload/attach as a part of the Application are:
Accessible Accordion

Scan of Academic Transcript(s) ensuring that all relevant information (e.g. degree and date conferred) are indicated and readable. The ACT Program DOES NOT require official transcripts sent and sealed from your conferring institution.

Scan of Professional License, Credential, or Certificate ensuring that all relevant information on the scans is readable.

Submit your most up-to-date resume or CV in PDF.

Submit a Letter of Reference in PDF from an individual who is familiar with the way you engage in your work in a related field. One letter is required, but do not submit more than 2.

Submit an Autobiographical or Personal Statement in PDF using the reflective prompts provided in the Sample Application below.

Download the ACT Program Sample Application Form here!

 

CLICK ICON TO GO TO ONLINE APPLICATION FORM: 

 

Back to Application + Fees

Contact Us:

Barnard Center for Infant and Early Childhood Mental Health

1959 NE Pacific Street | Health Sciences Building, F-356 | Seattle, WA 98195

Fax: 206-685-3284 – ATTN: ACT Program

Contact us by e-mail: BCact@uw.edu to join our mailing list, ask questions, or set up 1 to 1 meeting.