Graduate Skills in Counselling – Application Form

Title
Forename*
Surname*
Date of Birth*

Address 1*
Address 2*

Town/City*
Postcode*

Email Address*
Telephone Number
Mobile Number*

Nationality *
Country of Birth *
Do you have any special requirement?

Personal Statement

Please provide a personal statement to support your application, with a maximum word count of 300 words

Personal Statement *

University/College/Secondary School

Please provide a detailed description of your qualifications, ensuring your grades are displayed too:

From
To
University or College Attended
Qualifications (Including Grade)

From
To
University or College Attended
Qualifications (Including Grade)

From
To
University or College Attended
Qualifications (Including Grade)

Employment Details/Experience

Please provide a detailed description of your employment history and any experience you have undertaken which you feel would support your application for the Graduate Certificate in Counselling:

From
To
Organisation/Employer
Experience, Job Title

From
To
Organisation/Employer
Experience, Job Title

From
To
Organisation/Employer
Experience, Job Title

From
To
Organisation/Employer
Experience, Job Title

References

We require two references to support your application, these should be from either an academic or professional background. Please provide their details below.

Reference 1

Name
Reference 2

Name

Contact Number
Contact Number

Sometimes we may need to contact your references for further information. Do you give permission for us to contact your references if required? *
I acceptI do not accept

Which course date would you prefer?

Have you/are you applying for the MSc or PG Dip?
*YesNo

Once you have completed your interview, subject to offer and subsequent acceptance you will receive an invoice for the course fee of £1900 + VAT this has to be paid within 30 days or sooner if the course date is less than 30 days away. *
I acceptI do not accept

I understand that the programme is planned to go ahead face to face, however if guidance does not allow I accept that the programme will be delivered virtually. *
I acceptI do not accept

Graduate Skills in Counselling – Application Form

Personal Statement

University/College/Secondary School

Employment Details/Experience

References

Reference 1

Reference 2