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Ratcliffe & Brown CIC | ASIST Trained Crisis Support | Social Prescribing UK | Counselling Placement Provider
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Name Forename
Placement Application
Name
*
Preferred Pronouns
*
Telephone
*
Email
*
Date of Birth
*
Address
*
Qualifications
Qualifying course name
Name of training provider
*
Date your course finishes
*
Please add the date, or a rough date, when your counselling qualification course is scheduled to end.
Name of course accreditation body
Total number of client hours completed to date
*
What is the total client hours requirement by your course provider
*
Further Information
Applications are monitored for AI completion and deleted as spam. Please use your own words to answer the questions.
Are you engaging in personal counselling?
Yes
No
Have you organised private supervision?
Yes
No
Our supervisors are able to provide private supervision outside of group work that is funded by the supervisee. Please tick if you would like their prices emailed out to you
Yes
No
6 days of specialised training is provided. A certificate is provided for your CPD records. This is at a small cost of £250 and is instead of requesting a minimum placement time length or minimum client load. Please confirm you agree to this non-refu
*
Yes
No
Enter your current DBS number and issue date to be validated
Where else have you got a placement?
*
When would you ideally like to begin your client work?
What can you bring to our team?
*
Please help us to understand why we should offer you a placement and how your values fit our organisation's goals.
Why would you like a placement at Ratcliffe & Brown CIC?
*
Which of our three organisational goals do you identify with most and why
*
Demonstrate your understanding of self-reflective practice
*
How do you intend to use this tool to work ethically with clients?
Ratcliffe & Brown CIC provide counselling retreats each year for further development. Would you like to hear more about this in your interview
*
Yes
No
If you wish to attend the training without engaging in a placement, please select yes. For training only, you will not be required to attend an interview
*
Select an option...
Yes - I want to complete the training without engaging in a counselling placement
No - I want to complete the training and have a counselling placement
Please ensure you have filled out all required fields.
Submit
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