Full ApplicationPlease enable JavaScript in your browser to complete this form.1Your details2Questions3Referees4Declarations & FinishTitle of Unit of Training * e.g Diploma in Contemporary Psychotherapy.Name *FirstLastDate of birth *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email *Address *Telephone number *Questions >Employment (past, present, paid and voluntary). Please include dates. *Details of previous Psychotherapy or Counselling training and/or experience if applicable *Please include name of training institute(s), accrediting body, dates, number of classroom contact hours completed by you, qualifications, clinical practice hours, clinical supervision arrangement.Other Professional / Academic Qualifications (post 'A'Level) including name of institute(s) and duration of course(s) *Why do you want to enrol on this training? *Please describe your personal strengths, which you believe will assist you as a Trainee and Practitioner. Describe your personal challenges which you believe you need to address, or areas for development. *How do you intend to use the skills that you acquire from this training in personal and professional contexts? *Have you experienced any illnesses, accidents or physical conditions that might affect your training and where you might need further support during training? *Because of the vocational nature of this training, we need to know this information. Please give details including dates and treatment received or write 'none' if applicable. NB Providing this information will not prevent your Application from being successful.Do you have any special needs which you would like us to be aware of? *If yes, what strategies need to be in place to support your participation? Because of the vocational nature of this training, we need to know this information. NB Providing this information will not prevent your Application from being successful.Do you have any history of mental health issues/mental illness/psychiatric care, substance misuse/dependency? *< PreviousReferees >RefereesYou must provide 2 professional references within 7 days of submitting your online application using the Reference Form that can be downloaded from the course page on our website. The first referee should be your current or most recent employer / manager / supervisor / tutor of a course you have attended /colleague where you volunteer / community leader of group you attend / client if you are self employed. The second referee can be a previous employer / manager / supervisor / tutor of a course you have attended / colleague where you volunteer / community leader of group you attend / client if you are self employed. We cannot accept References from friends & family.< PreviousDeclarations & Finish >InterviewIf your written application is successful you will be invited to attend an individual interview online using Zoom. This usually lasts for approximately one hour and with 2 senior members of our team. This is a supportive process during which we establish if this is the right training for you and where appropriate how we may be able to count some of your existing qualifications towards our final qualification. We will contact you with the outcome of the interview. Any offer of a place is subject to provision of satisfactory references. You will also be required to complete an Enrolment Form and make appropriate payment of fees before we can confirm your place.Please tick here to confirm that you agree to pay the £50 Application Fee. *I agree to pay the £50 Application FeeAfter clicking the Submit button at the end of this application you will be redirected to a different page to make payment of the £50 Application Fee. We will send you an email confirming receipt of your application. In the event of your application not being successful you may use the application appeals procedure. Unsuccessful applications & appeals will result in your £50 application fee being refunded minus a £25 administration fee.DeclarationPlease tick here to confirm this information is correct *I confirm that the details on this application are correct to the best of my knowledge.Privacy Statement *I consent to BeeLeaf collecting my personal information.Your personal information will only be used in relation to the purpose for which it is provided. See our Privacy Policy here: https://www.beeleaf.com/privacy-policy/Terms & Conditions *I confirm I have read and agree to the Terms & ConditionsPlease read the payment terms & conditions on the course page of this websiteCriminal Offence Data *I understand that I will be required to undergo a DBS check with my Clinical Practice Placement ProviderI understand that if I have any unspent criminal convictions I should contact the BeeLeaf office to discuss this prior to submitting an applicationStudents enrolled on the BeeLeaf 'Clinical Practice & Comparative Psychotherapy' unit of training required for the award of the BeeLeaf Diploma are normally required to undergo a DBS check with their clinical practice placement provider. Results may affect Therapists working with children and vulnerable adults and those in private practice.< PreviousWebsiteSubmit application and checkout