APPA CAS Release Statement

I certify that all of the information submitted by me in this application is true to the best of my knowledge and belief. I understand that any significant misstatement in, or omission from, this application may be cause for denial of selection as a postdoctoral resident or dismissal from a postdoctoral resident position. I release from liability all postdoctoral program staff for acts performed in good faith and without malice in connection with evaluating my application and my credentials and qualifications. I also release from liability all individuals and organizations who provide information to the postdoctoral program site in good faith and without malice concerning my professional competence, ethics, character, and other qualifications now or in the future. I authorize the internship site and my doctoral program to release evaluative information about me to each other, now or in the future.

I further understand that it is my responsibility to inform the postdoctoral program sites to which I have applied if a change in my status with my academic program, (e.g., being placed on probation, being dismissed, etc.) occurs subsequent to the submission of my application. In addition, I understand I have the same responsibility to inform the postdoctoral program site to which I match if a change in status occurs after final selection has occurred.

If I am accepted and become a postdoctoral resident, I expressly agree to comply fully with the Association of Psychology Postdoctoral and Internship Centers (APPIC) policies, the Ethical Principles of Psychologists and Code of Conduct and the General Guidelines for Providers of Psychological Services of the American Psychological Association, and with the standards of the Canadian Psychological Association which are applicable. I also agree to comply with all applicable state, provincial and federal laws, all of the Rules and Code of Conduct of the State or Provincial Licensing Board of Psychology, and the rules of the institution in which I am a postdoctoral resident.

I understand and agree that, as an applicant for the psychology postdoctoral residency program, I have the burden of producing adequate information for proper evaluation of my professional competence, character, ethics, and other qualifications and for resolving any doubts about such qualifications.

I hereby agree that personally identifiable information about me, including but not limited to my academic and professional qualifications performance, and character, in whatever form maintained, may be provided by my academic program to any postdoctoral training site to which I have applied and/or will match. This authorization, which may be revoked at any time, supersedes any prior authorization involving the same subject matter.