Integration Psychotherapy Course Application

Integration Psychotherapy Diploma Course

Official Course Application
Welcome to the training course application for Integration Psychotherapy. We are committed to simplifying and refining our operations while protecting your data. This step in the process requires you to disclose personal details, including any previous education, acknowledge the therapy requirements of the course, and discuss why you would like to become an integration psychotherapist. The next step is for you to complete six self-reflective (non-graded) questions in no more than 3700 words. We have another online form (link on page 5) for you to submit your answers and supply details of two referees.
Cohort Start Date*

15th December 2025 - Eyam
Applicant Details
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityRegion

Post Code
Email Address*
example@example.com
Phone Number*

Education
Please include any relevant prior learning to show you meet the requirements to undertake training at this level, e.g., Level 5 - 7
Name of School/Organisation *
Course Taken*
Award Type *
Date Awarded*

MonthDayYear
Date
Add Education or Prior Learning?

YesNo
Name of School/Organisation
Course Taken
Award Type
Date Awarded

MonthDayYear
Date

Additional Information
Have you trained with The Pilamaya Centre or Shaura Hall before?*

YesNo
Is this your first time applying to this course?*

YesNo
When did you last apply?*
(dd-mm-yyyy)
Are you prepared to meet the Personal Therapy requirements for this course?*

YesNo
Why would you like to become an Integration Psychotherapist?*

0/200

Course Fees
Are you are prepared to pay the holding deposit to secure your place (if offered) on the course?*

YesNot Sure
Would you like to be contacted to discuss payment plan options for the remainder of the course fees?*

YesNo
Application Portfolio
The next step is for you to complete six self-reflective (non-graded) questions in no more than 3000 words. The online form allows you to save an continue working on it at another time.

Go here to access the portfolio form
Application Fee
We charge an application fee to cover the time it takes to review and process your application. We deduct £30 from your deposit once you have been accepted onto the course.
My Products*
prevnext( X )
Application Fee£30.00
Non-refundable

Quantity

Total £0.00

Certify & Submit
By signing below, I certify that the information I have provided above is true to the best of my knowledge without any malice or any intent to commit acts of misrepresentation. I am also aware that any intentionally false, misleading, or deceptive information provided may result in the automatic refusal of my application or subsequent withdrawal from the course, without recourse to a refund of monies paid towards my course fees.
Applicant's Name*

First NameLast Name
Signature

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Date Signed*

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Date
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Integration Psychotherapy Diploma Course