COSCA Certificate Application Form
Please complete all sections of this form. Information provided will be used to assess your application for the COSCA Certificate and to contact you about your application. If successful we will invite you for an informal chat online to discuss your application further.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Permission to contact
*
Yes
No
Preferred contact method
*
Phone
Email
Either/Both
Preferred days/times to contact
*
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Qualifications
*
Rows
Qualification/Course
Institution/Provider
Date Completed
1.
2.
3.
4.
5.
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Work Experience
*
Rows
Organisation/Employer
Role
Duties
Dates To - From
1.
2.
3.
4.
5.
Please tell us about any additional needs, adjustments or support requirements:
*
Max 300 Words
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No formal educational qualifications are necessary; however, you should make it clear on the application form why you wish to take the course, by answering each question below fully.
What is your understanding of ‘counselling skills’?
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Max 300 Words
Why do you want to do this course?
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Max 300 Words
What skills and qualities do you have that you will bring?
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Max 300 Words
What experience (if any) do you have of counselling skills?
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Max 300 Words
The course is experiential and can be emotionally demanding. How comfortable are you with this and how do you know?
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Max 300 Words
How comfortable are you in exploring your self-awareness and how do you know?
*
Max 300 Words
What support do you have in place to help you balance the demands of the course alongside other commitments?
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Max 300 Words
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Please note:
If successful at application, you will be required to attend an informal chat to allow us to get to know you a little more and allow you to do the same. If you have had a significant traumatic life event or a recent bereavement, then please make this clear within your application and we can discuss this confidentially during the informal chat.
Declaration:
I confirm that the information provided is accurate and complete to the best of my knowledge.
*
Please Select
Yes
No
Signature
*
Submit
Should be Empty: