Apply for Placement - The Ash Counselling

Personal and Contact Details

Full Name *

Email Address *

Address *

Phone Number *

Date of Birth *

Emergency Contact Name *

Emergency Contact Number *

Education and Training

What counselling qualification are you currently working towards? *

Training Institution *

Course Name *

Does your course require personal therapy? *

Yes, and I have started

Yes, but not started yet

What stage are you at in your training? *

Previous counselling or related training

Professional body membership (e.g., BACP, UKCP, NCS)

Placement and Experience

Previous counselling placements

Type of client work experience

Client hours completed

Counselling approach/modality *

What are you hoping to gain from this placement? *

Personal Qualities and Motivation

What draws you to a career in counselling? *

How do you take care of your own wellbeing and self-awareness? *

Ethics, Supervision, and Safeguarding

How do you ensure your practice remains ethical and within professional boundaries? *

Safeguarding training completed

Do you have a current DBS check? *

Yes, I have a current DBS

No, but willing to undergo DBS check

Availability and Practicalities

Client hours per week desired *

When can you begin placement? *

Days and times available *

Supervision Information: We offer group supervision for all trainees. Individual supervision is provided based on the number of clients you have (minimum is 4 clients).

References

Course Tutor/Placement Coordinator Name *

Contact Details *

Second Referee Name *

Contact Details *

Required Documents

CV *

PDF, DOC, or DOCX format

DBS Certificate

If available

Readiness Confirmation *

Letter confirming readiness to work with clients

Declaration

I confirm that the information provided is accurate and complete. *

I consent to Ash Counselling Ltd contacting my referees and training institution. *