Earth Wisdom Therapy

info@earthwisdomtherapy.co.uk

Earth Wisdom Ecotherapy Community Interest Company

Volunteer Counsellor Application Form

At Earth Wisdom, we provide reduced-cost counselling to people across Gloucestershire who may not otherwise be able to access therapy. As a not-for-profit Community Interest Company (CIC), our mission is to make mental health support more accessible, inclusive, and affordable - particularly for those facing financial barriers.

We ask for a minimum commitment of one year to ensure continuity, stability, and consistency for the clients we serve.

This application form is designed to help us understand your training, experience, interests, and how you hope to contribute to Earth Wisdom.

The information requested enables us to appoint suitable practitioners and to uphold our safeguarding responsibilities to the children and vulnerable adults we work with.

Although this is a volunteer role, it carries professional responsibilities. Appropriate training, supervision, insurance, and safeguarding checks are required.

All post holders will be required to undertake an Enhanced Disclosure and Barring Service (DBS) check and provide evidence of their right to work in the UK.

Thank you for your interest in joining Earth Wisdom and contributing to ethical, professional counselling that supports people who might otherwise be excluded from care.

Vacancy Title

How did you hear about this Vacancy?

First name

Last name

Phone

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Do you identify as having any disabilities, long-term health conditions, access needs, or allergies that you would like us to be aware of in relation to this role? This information is optional and shared to help us offer appropriate support.

Emergency Contact Name

Emergency Contact Phone

Relationship to you:

Qualifications & Experience

Counselling Training

Counselling CPD Qualifications

Counselling Experience

Total Number of Supervised Clinical Hours to Date

Personal History

Do you currently have a supervisor?

Do you currently have professional indemnity insurance?

Yes

Which recognised professional body are you registered with?

BACP

NCPS

UKCP

Do you currently have an Enhanced DBS Certificate?

Yes

Upon joining the CIC, I acknowledge my responsibility to obtain and maintain an up-to-date Enhanced DBS check and hold professional insurance, including the obligation to renew and update these documents as required.

Employment History

For each role, please include where possible: organisation name, role/title, dates involved, and a brief description of your responsibilities (up to 500 words in total). If there are gaps in your experience, you are welcome to share a brief explanation

Please share your availability below:

Please note that volunteer client hours may vary depending on referrals, funding, and suitability.

Times (broadly speaking)

9am - 3pm

4pm - 9pm

Other

* How many client hours per week could you take on?

* Are you comfortable offering a mix of indoor and outdoor therapy?

Funded clients are offered a series of 12 therapy sessions. While some of these may take place outdoors, some will be indoors, particularly for clients who are new to ecotherapy and may need time to adjust to the experience.

* Do you have specific client groups you specialise in or prefer to work with?

Additional Information

What draws you Earth Wisdom Ecotherapy CIC and our approach?

* Is there anything else you’d like to share about your skills, experience, or expectations?

Professional Reference

Please provide the contact details of at least one professional reference who can speak to your qualifications, experience, and character in relation to this role.

When can you start?

Declaration

All information in this application is true and correct to the best of my knowledge and belief.

I understand that Earth Wisdom Ecotherapy CIC works within an ethical, trauma-informed and neurodiversity-affirming framework, and I am willing to reflect on my practice within this.

I consent to EWECIC undertaking all necessary checks, including verification of qualifications, professional membership, references and a satisfactory DBS/criminal record check.

I confirm that I have the right to work/volunteer in the UK and will be able to provide proof of status at commencement of this role.

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Once we have reviewed your application, we will contact you to arrange an opportunity to meet and discuss how we can work together. Please let us know when you are free to attend.

Thank you for your time and interest!