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  • Level 4 Diploma in Therapeutic Counselling (TCL4) Application Form

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  • Please Include: Course title and qualification. Training provider/institution. Whether the course was completed online, in person, or blended. Whether the course was CPCAB accredited. Whether clinical triad work was included as part of the training and practice with peer.
  • Please give details of two people who can provide a reference for you. Please include your Level 3 Tutor *
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  • Have you been the subject of a formal disciplinary sanction in your current employment/course?
  • Are you in the process of on-going disciplinary proceedings in your current employment/course? **
  • Have you been the subject of a formal disciplinary sanction in any previous employment? **
  • A full DBS check will be required before the start of the course. Do you have anything to declare as part of this process? **
  • A non-refundable deposit will be required once a course place is offered in order to secure your place. We offer two package options and various payment options (please see our website for full details) Please select below your preferred option. No payment due until course place accepted.
  • I confirm that the details that I have provided in this application form are correct, and that I have not deliberately withheld any relevant information.

    I understand that the deliberate falsification of information, failure to disclose relevant information or an act of canvassing on my part, may lead to my application being rejected, any offer of a place being withdrawn.

    I understand that it would be a criminal offence for me to apply for a post that involves working with children, young people and / or vulnerable adults if my name is included on the Independent Safeguarding Authorities List of those barred

  • I consent to my data being stored for the statutory, or recommended, retention periods when I am no longer a student at Quetzal. *

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