Student Application Form | Earth Wisdom Ecother

Earth Wisdom Ecotherapy Community Interest Company

Student Counsellor Volunteer Application Form

Client Role: to offer therapeutic support to clients in a safe, ethical, and professional manner as part of the counselling placement.

CIC Role: to adhere to the Volunteer Counsellor Agreement by upholding the policies and procedures of EWECIC, ensuring a safe, supportive, and ethical environment while actively contributing to the organisation's mission and goals.

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Emergency Contact Name

Emergency Contact Phone

Relationship to you:

What inspired you to apply for a volunteer placement with Earth Wisdom Ecotherapy Community Interest Company?

Do you currently have a supervisor?

Do you currently have professional indemnity insurance?

Yes

No

Which recognised professional body are you registered with?

BACP

NCPS

UKCP

Other

Are you open to incorporating ecotherapy approaches into your practice and participating in related training?

Do you have any experience, training, hobbies, or interests that relate to ecotherapy practices, and how have they shaped your understanding of the therapeutic process?

Do you identify as having any disabilities or medical conditions, including allergies, that we should be aware of in relation to your role? If so, please feel free to share.

I commit to actively engaging in peer supervision sessions as required by EWECIC, fostering a supportive and collaborative environment that promotes professional development and personal growth.

Additionally, I commit to upholding and embodying the policies and procedures of EWECIC, including the Risk Protocol and Safeguarding Policy, to ensure a safe and nurturing therapeutic environment for all clients while supporting the organisation's overall mission.

Please share your availability below:

Times

9am - 3pm

4pm - 9pm

Are you able to see a minimum of three clients each week for 50-minute sessions, committing to at least 12 sessions per client, unless otherwise agreed?

Do you have a preferred start date?

Do you know someone in our team?

Yes

No

Name & Relationship

To be considered for the voluntary placement you will need to attend an interview. Please share any specific requirements you may have to facilitate your participation in the interview process.

If selected after the interview, I acknowledge my responsibility to maintain and hold professional insurance, including the obligation to renew and update as necessary.

Signature

Signature field is empty.

Earth Wisdom Therapy

info@earthwisdomtherapy.co.uk

Student Counsellor Volunteer