Application for the Professional Licentiate in Acupuncture

Some tips on completing this form

Before filling in this form please note that there is the option on each page to Save your progress. Clicking on Save at any point in your application then will trigger an email to the address that you have given, allowing you to return and complete your application at a later date. We won't see what you have written until you click on the final Submit button though, so don't worry if you aren't yet happy with what you have written!!

A couple of additional notes:
- you will be asked for a personal statement regarding your reason for wishing to study acupuncture, which you might find easier to write elsewhere before starting, cutting and pasting it into your final application when you are happy with what you have written
- you will also be asked to upload documentation to support your application at the end, and we are happy for these to be photographs of the originals.
If you have any questions or particular difficulty completing this form though, do feel free to get in touch with us through the Contact Us button at the top of the homepage on our website. We are always happy to help, and won't hold it against you ;D....
Application for the Professional Licentiate in Acupuncture
Please note: Any personal information that you give us will be processed in accordance with the UK Data Protection Act 1998. The information will be used for the following purposes: to enable us to create a computer and paper record of your application, to enable the application to be processed, to enable us to compile statistics or to assist other organisations such as accrediting bodies to do so, provided that no statistical information what will identify you as an individual will be published. The information will be kept securely, and no longer than necessary, and will be disposed of in line with the declaration below:
Submission date

Day Month Year
Date
DESTRUCTION DATE FOR PROSPECTIVE STUDENT PERSONAL DATA

FOR OFFICE USE ONLY:

Application forms will be destroyed 24 months after the date of application (in the case of a non-starter), or Graduation date, whichever is the latest, along with personal data stored on all hard copy enquiry forms, electronic register enquiry forms, or in any email correspondance.
Name:

Prefix First Name Last Name
Do you have a preferred name (for the register etc)?
Leave empty if the answer is 'no'
Address:

Street Address

Street Address Line 2

Town /City County

Postcode Country
Home phone number:

Area Code Phone Number
Mobile phone number:
Email:
example@example.com
Please confirm email:
example@example.com
Date of birth:

Day Month Year
Date
Gender:
Ethnicity:
Where did you hear about us? *

Further tips on completing this form

A quick note that from this section onwards, if you wish to make a text box wider, and see several dots in the bottom right hand corner, then you can do so by simply dragging them to the right a little. You can also delete a row by clicking on the 'X' to the right of an entry if needed. Expanding a text box might make it easier for you, but either way your text will come through to us in a nice, neat format regardless.

In addition, if you need to add more lines, for example where we ask for two referees later, and only one line is showing, simply click on the '+' button.
Education history and qualifications

- please add the highest and most recent first, using the + button to add more rows
Qualifications:
Informal education eg CPD courses:
Are you a member of any professional bodies?
If yes, please give details

Employment history

- please detail all work, both paid and unpaid (if relevant). The 'description' box can be dragged and extended to the right to give you more space for writing
Work history:
Current and future work commitments:
Please tell us your current working hours, and whether there is a degree of flexibility here, and/or do you plan on cutting down during your time studying?

Why do you want to study acupuncture now?

You might include experience as a patient, life experience, and informal work or studies (up to 800 words) 0/800
Why have you chosen TAA?
Your preferred cohort
Please state March or September, followed by the year e.g. March 2021
If you would like to join the waiting list for an earlier group, please let us know here

Disability and studying

Please note that The Academy operates a widening participation/equal opportunities policy, and will consider applications from people with a disability as long as basic fitness to practice criteria are met

In this section we are also asking whether an applicant believes that they may have a learning difficulty (eg dyslexia), either diagnosed or undiagnosed. This is so that we can provide additional support if needed.
Disability and study support *
Please provide brief details of any disability or difficulty that may affect your abillity to study or practice, as well as any adjustments or support that you might require in order to complete your studies
Self declaration of criminal record and cautions

- please note that convictions normally considered 'spent' must also be declared
Cautions / convictions: *
If you have answered 'yes' to either of the above, you may wish to write a brief statement in support of your application and place this in a sealed envelope, marked 'Confidential, for the attention of Admissions' and bring it for consideration at interview

References

You should give two references from people who are not related to you, but who have known you for three years or more. One should be a current or previous employer/tutor, and one could be your acupuncture practitioner, if you have one. They will be contacted and asked to give their opinion as to your suitability to undertake this course
First reference (please include name, an email address, and their connection to you):
Second reference (please include name, an email address, and their connection to you):
Supporting documentation

And finally, could you attach a copy of these documents to support your application. If there are any gaps then you can email them in at a later date, but it is preferable to have everything in one place. Photographs of these, taken on your phone, are perfectly acceptable:
- A copy of your most recent/highest educational qualification
- Proof of current address such as utility bill or bank statement
- Proof of identity bearing your name and a photograph, such as passport or driving licence
- A photo for our register and your student card (you are allowed to smile!)
And for non-British nationals we will also need:
- Proof of residency status and identity
- IELTS level 6.5 if English isn't your first language AND if your secondary education was not undertaken in English. This will be required prior to starting the course if you don't have it already
Tick the documentation that you have attached here:

Photo for the register (you are allowed to smile!) Educational qualification Proof of current address (eg utility bill) Proof of identity Proof of residency (non-British nationals) IELTS level 6.5 9 (non-British nationals)
Please upload your supporting documents here (see list above): *

Browse Files

Cancel of
And finally, just for our records, have you attended a preview session?
Please write your name here in lieu of a signature, and date this. We will ask you to sign the box on the right at interview *
And finally, by submitting this application, you are guaranteeing that all of the information contained within it is correct, to the best of your knowledge. You are also acknowledging that if at a later date it is discovered that this application is not entirely truthful, you understand that you may be liable to disciplinary action, and in the most serious cases, removal from the course with no recourse and no entitlement to a refund *

I acknowledge that I have read this, and to the best of my knowledge, all information contained in my application is accurate Can I take a raincheck on this question??
Please verify that you are human (hopefully an easy one!!) *
Should be Empty:

Application for the Professional Licentiate in Acupuncture

Education history and qualifications

Employment history

Disability and studying

Self declaration of criminal record and cautions

References

Supporting documentation