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Volunteer Counsellor /
Placement Student Application

If you would like to apply to be a  Volunteer Counsellor or a Placement Student, please complete the form below and we will be in touch to discuss your application.

Date of Birth

Voluntary Work (Most recent first)

Please provide details of any voluntary work including Dates, Organisation, Role/Activity and Reason for Leaving.

Employment (Most recent first)

Please provide details of employment covering Dates employed, Organisation, Role/Activity and Reason for Leaving.

Counselling Training

Please indicate the name of your training institution and its awarding body e.g CPCAB, BACP or UKCP and the approximate duration.

Formal Counselling Qualifications (most recent first)

Please include Title of Course, Dates/Duration, Qualifications and the Name of College/Training Provider.

Additional Qualifications (education/professional) (Most recent first)

Please include Dates, Name of College and Accrediting University along with Qualification gained.

Have you completed your College to Practice Assessment?
Yes
No

Counselling Experience Details

Supporting Statement (for additional page please upload file)

In this section, please give any additional information to support your reason for your interest in becoming a volunteer counsellor / placement student at Youthline and include any strengths or interests you have to bring for the benefit of Youthline.

References

Please give the name, position, postal address and email address of two people to whom reference can be made. One should be personal (not a relative) and one professional.

YouthLine takes up references for all applicants.

Health Declaration: Do you have, or have had, any medical condition of which we, as a responsible voluntary organisation, would need to be aware?
Yes
No

Declaration

  • You are required to sign the declaration below certifying that all the information you have provided is accurate.

  • YouthLine will check the details you have provided.

  • Providing incorrect information or deliberately concealing any relevant facts may result in disqualification from the selection process or, where discovery is made after an appointment, in summary dismissal.

Youthline is committed to safeguarding and promoting the welfare of children, and expects its entire staff and volunteers to share this commitment.


I have read and understood the Youthline Data Protection Statement and Privacy notice found on our website http://www.youthlineuk.com/get-involved/

 

I declare the information on this form is correct and I have omitted nothing that, to the best of my knowledge, might affect this application.


Before submitting your application please make sure to upload relevant Qualification / Training certificates.

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