Placements

Closing date for application is 10 January 2019.

Our Clinical Supervision takes place fortnightly on Fridays from either 9:30 am - 11 am or 5 pm - 6:30 pm *

Please indicate if you can commit to attending Supervision at either of these times.

Yes

Preferred clinical supervision time *

9:30 am - 11 am

5 pm - 6:30 pm

Title *

First name *

Surname *

We can only accept applications from people able to commit to Supervision fortnightly on Friday mornings from 9.30 am - 11 am.

Address *

Postcode *

Contact number *

Email address *

Current Training / Qualifications *

Please give details of any current training and qualifications, please also include the date carried out and the training provider details.

Previous Training / Qualifications *

Please give details of any previous training and qualifications, please also include the date carried out and the training provider details.

Describe any relevant work experience *

Please give details of any previous or current work placements, please also include the date carried out and the placement provider details.

Number of clinical hours and the setting *

Describe your therapeutic approach *

(Integrative, psychodynamic, CBT, Humanistic, TA, or other)

Supporting statement (no more than 300 words please) *

Do you have a current DBS check? *

Yes

BACP membership number

Leave blank if you're not a member.

UKCP membership number

Leave blank if you're not a member

Can we contact you tutor or training provider? *

Yes

Can we contact any previous placement provider? *

Yes

References *

Please provide a name, address, post code, email address and contact number for 2 referees who must be a current tutor, previous tutor or placement manager/supervisor relevant to counselling practice and training.

Submitting this form will act as an e-signature and you are acknowledging that the information you have provided is honest and true.

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Placements