AASWNth Qld Supervisor Register Member Profile

SUPERVISOR REGISTERBOOKING FORM

The Australian Association of Social Workers Ltd (North Qld) often receives requests from individuals and organisations seeking supervisors, counselors, report writers, consultants and trainers. In order to meet the needs of members the AASWNthQld will maintain a Supervisor Register on the North Queensland webpage of the AASW website.

We invite suitably qualifiedcurrent members (2012 - 2013) to submit a one pageprofile for inclusion in the Supervisor Register 2013.Eligibility to register is subject to the member financial and accredited Member of the AASW status.Once included on the Supervisor Register registrants must continue their AASW membership to maintain the listing. Should either of these status’ lapse, then your name will be removed from the register.

Enclosed is a sample profile along with a blank template. Please fill in your details, save this document as a Word file using the format SURNAME Given PPR0910 (e.g. SMITH Mary PPR0910) and send it to AASW Nth Qld Branch Office ManagerLouise Masters, via .

Consent to Publish

Please ensure that you only provide details (particularly contact details/locality) which you consent to being made public. For example, you may choose to list your suburb rather than your full address.

Please don’t hesitate to contact Louise on 0428 489 683or ould you have any queries.

SUBMISSIONS CLOSE:14February 2013

EXAMPLE PROFILE

<Name> DOUG BURKE
TELEPHONE / BH 07 3300 6845 / 0419 963 142
E-MAIL/WEB / /
LOCALITY / Bardon Counselling Centre
Boundary StreetRAINWORTH / 10 Dungory Street
THE GAP QLD 4061
SERVICES /
  • Consultancy
  • Program Development – Fitness Integrated Therapy programs(e.g. FIT2Beat Depression)
  • Groupwork
  • Counselling
  • Online support
  • Supervision
  • Training

SPECIALTY AREAS/PRACTICE EXPERTISE AND INTERESTS /
  • Post trauma reactions (veterans their families, survivors of crime, violence abuse)
  • Relationship counselling (particularly following trauma)
  • Anger Management
  • Depression

YRS OF EXPERIENCE / Twenty-three (23)
QUALIFICATIONS / Bachelor of Social Work (Hons), Uni of Qld
MEMBERSHIP
Everyone listed is an AASW member at time of publication. / Accredited Member of AASW /  YESType: MAASW (Acc)
 NO
Other Memberships / ACISA
AFTER HOURS / Weeknights 5 – 8pm (by apt only) / HOME/AGENCY VISITS / No
OTHER INFORMATION / Doug offers treatments and programs using his innovative fitness integrated therapy methodology. Doug, through his company theraFIT, offers a range of services which address physical and psychological health and wellbeing (mind body unity). theraFIT as a private health provider project manages the HeartHealth Program for Vietnam Veterans Counselling Service. This is a year long group based exercise program delivered in up to 23 locations in QLD.

Consent:

I, …………………………………………… (name) give my permission for the above personal details under Section 2, to be put on the AASW (North Qld) branch section of the website and/or to release my details.

Signed: …………………………………………………………………………. Date: …………………………………………………..
PLEASE COMPLETE AND SUBMIT

NAME
TELEPHONE
E-MAIL/WEB
LOCALITY
SERVICES
SPECIALTY AREAS/PRACTICE EXPERTISE AND INTERESTS
YRS OF EXPERIENCE
QUALIFICATIONS
MEMBERSHIP
Everyone listed is an AASW member at time of publication. / Accredited Member of AASW /  YESType:
 NO
Other Memberships
AFTER HOURS / HOME/AGENCY VISITS
OTHER INFORMATION

Consent:

I, …………………………………………… (name) give my permission for the above personal details under Section 2, to be put on the AASW (North Qld) branch section of the website and/or to release my details.

Signed: …………………………………………………………………………. Date: ………………………………………………