Application Form (UOL)

Application Form

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NB: On receiving the completed application form we will be in touch.

First Name*

Surname*

Business Address Number*

Business address Street Name*

Business Address Town*

Business Address County*

Business Postcode*

Business Contact Number*

Email Address*

Insurance*

PDF format only

Accredited with*

Confirm which membership body you are accredited with? BACP/UKCP/NCPS Professional. Full accreditation with either BACP, UKCP or NCS (Accredited Professional Registrant) is an essential requirement

Accreditation Number*

Accreditation Expiry Date (dd/mm/yyyy format)*

Accreditation Certificate*

PDF format only

Current Supervisors Name*

Supervisors Email*

Hours of Supervision Per Month*

CV*

PDF format only

Counselling Qualification*

PDF format only

Modality*

Provide information about the theoretical approach(es) you use when working with a workplace client. (approx. 200 words)

Work with*

Individuals / Couples / Groups

Provides*

F2F / Zoom / Phone

Contracting*

What specific issues / challenges does a workplace counsellor have to consider when performing their role? How does workplace counselling differ from other types of counselling provision? (approx 250 words)

Comments

Is there any other information / experience details you would like to provide? (For example, additional languages / business experience / case management experience)

* required fields

Clients we've worked with