ESS Course Application

Mentor proposal

The ESS-mentor is an SLT specialized in fluency disorders with proved evidence of continued professional development in the last 5 years. After contacting the possible mentor about his/her willingness to mentor, the applicant suggests 1 (or 2 in case of insufficient hours) persons (ideally in his/her own country) who could take on the role of mentor. The mentor’s primary role is to provide guidance and support to the trainee based on his or her unique developmental needs.The mentor will need to be approved by ESS.
First mentor*

TitleFirst NameLast Name
Email*
Phone number*
Second mentor*

TitleFirst NameLast Name
Email*
Phone number*

Motivational letter

The maximum file upload size is 500kb per document.
Describe in max. 500 words (English) your motivation for taking part in this specialization course.*

0/500
Alternatively, upload a file with your Motivational letter.

File type: pdf
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Clinical plan

The maximum file upload size is 500kb per document.
Participants are required to do 120 hours of clinical work consisting of a minimum of 100 hours of therapy with a minimum of 5 clients (individual therapy, group therapy, family guidance) and a maximum of 20 hours of observation. It can start after the first intensive week. This clinical training is supervised by an external mentor and an ESS-coach. Describe in max. 300 words (English) your plan to meet the required hours.*

0/300
Alternatively, upload a file with your Clinical plan.

File type: pdf
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Submit your application
Terms & Conditions*

I accept the Terms & Conditions of this application.
Communications consent*

I consent to receiving communications from ESS regarding my application.
Declaration*

I declare the information I provided to be as accurate as possible.
Signature*
Type in your full name in BLOCK CAPITALS
Please verify that you are human*
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Application form