APPLICATION FORM
Person-Centred Therapy Britain
Certificate in Person-Centred Counselling Supervision
NAME........................................................................................................
ADDRESS..................................................................................................
.....................................................................................................................
.....................................................................................................................
TEL..............................................EMAIL...................................................
1. TRAINING
1.1
Counselling qualifications
Date of
qualification
1.2
Details of Training- length, number of
hours, details of theoretical orientation
1.3 Have you received
previous supervision training? Please give
details
2. EXPERIENCE AS COUNSELLOR
2.1
Details of previous and
current counselling practice, including the context in which counselling has
taken place (agency, institution, private practice,etc); number of clients and
client hours; clients’ issues etc
2.2. What are you current arrangements for supervision of your counselling
work?
2.3
Are you a member of BACP, COSCA or other
professional
body that
has a Code of Ethics and Practice?
[ ]
yes [ ] no
3.
EXPERIENCE AS SUPERVISOR
3.1 How long have you
been working as a supervisor?
3.2 Details of
supervision practice, including context in which supervision takes place (agency, institution, private
practice etc); number of supervisees and supervision hours; trainees or
experienced etc.
3.3 If you do not have a
current supervision practice, what are your plans for setting up supervision
opportunities during the course? ( It is recommended that you have this in
place before the start of the course)
3.4 Describe your
approach/model of supervision, as a supervisor
and/or as a supervisee
4.
PERSONAL STATEMENT
Please make a
brief statement about your reasons for wanting to participate in this training
course and add any other information you feel is relevant to this application
Signed............................................................Date...................................
Please
enclose one reference with this application and send a paper copy of the form
and the reference to PCT Professional Development, 40 Kelvingrove Street,
Glasgow G3 7RZ, or email both to elke.lambers@virgin.net