Diploma in Transpersonal and Integrative Supervision Application Form

As this is a very long form, some users might find it easier to download a copy, work on it offline and then email your application via email.

1) Personal Details

Title

First Name *

Last Name *

(as it appears on your passport)

Address *

Postcode

Your Email *

Home Tel

Work Tel

Mobile

Date of Birth *

Please note that assignments are submitted electronically. This means you will need to have personal use of a computer and printer as well as access to the internet and email. The Trust is not able to provide students with this facility.

What is your nationality? *

What is your country of birth?

What is your country of permanent residence? *

Please note that our courses are part-time and awarded by The University of Middlesex.

Declaration:

Please state: Do you have a criminal record that might prejudice the interest of clients or counselling, to be taken into account in considering this application? Have you been refused membership of a professional body or register in a related field on the grounds of professional misconduct in the United Kingdom or abroad? Please declare all relevant pending criminal, investigatory or disciplinary proceedings or enquiries below.

2) Please answer the following questions

Qualifications gained outside the UK should be entered as they were awarded and not translated into UK equivalents. Please note you may be asked to provide evidence of qualifications. Qualifications (Please list below in date order starting with the most recent)

University / College / School

Qualification and awarding body

Subject(s)

Results in full

Month MMM / Year YY completed or expected to complete

What language was this assessed /examined in

3) Please answer the following questions

Please state your professional membership details. *

Please state any previous therapeutic work on self, both individual and group, including the type of therapy, duration and number of sessions. *

Please tick this checkbox if you have any medical conditions that you are currently being treated for?

Please tick this checkbox if you are presently or have you ever undergone psychiatric treatment? Or you currently, or ever have received medication for psychological disturbances.

4) Clinical Experience

It is a pre-requisite that applicants are practising counsellors or therapists with a minimum of 350 appropriately supervised clinical hours. Please provide the following information:

Have you completed 350 supervised clinical hours? (Please note you will be asked to provide evidence of this.) *

Yes
No

Please provide the following information on your supervised practice since obtaining your counselling qualification or equivalent:

The form of supervision you have received

The frequency and duration of supervision

Total number of supervision hours specifying whether individual or group

Name and accreditation details of your current supervisor (e.g. UKCP, UKRCP, BACP accred etc)

5) Personal statement:

Our courses at the Psychosynthesis Trust have a strong experiential aspect to them. We ask all candidates to write a personal statement, which helps us to form a picture of you and your training requirements. We have provided some guidance below on areas to focus on and explore. You are free to include additional information about yourself and although we encourage you to answer each question it is not obligatory. All the information provided is held in the strictest confidence.

Questions to explore:

What is your purpose in applying for this course, and why at this time?

What is your professional background?

Please expand on your previous counselling/psychotherapy training and qualifications, including number of contact hours, duration of course and any experiential group work

Additional Needs

As an inclusive organisation, we want to provide the best support possible to a wide range of applicants, including those with additional needs. Additional needs include any disabilities or supplementary educational needs that you may have such as physical or sensory impairments; mental health difficulties including depression; specific learning difficulties like dyslexia and aspergers; and health conditions such as HIV, epilepsy, arthritis and cancer.

The information that you provide here will not be used to assess your academic suitability for the programme but to ensure that, if you are made an offer to study, we are aware that you may need extra support.

How did you hear about our training?

Word of mouth
Internet search
Advert (please specify where below)
Other (please specify below)

Please submit your application together with payment and one written reference (which include contact details of the referee). The reference should be from your supervisor who can vouch for your suitability to attend this course. Course fees and payment methods can be found on the Price Guide.

Please note that applications will not be assessed unless accompanied by payment.

Reference 1

I have read and understood the Financial Terms and Conditions for this application. *

Name

Join our mailing list

Type the characters you see in the image below * captcha

Online Application