COUNSELLING VOLUNTEER APPLICATION FORM – CONFIDENTIAL

Please note that to be a counsellor with Age UK Brighton & Hoveyou must either be qualified to degree level, Postgraduate Diploma standard, or in the final year of such training. You must work to the BACP Ethical guidelines and standards. You should ideally have some experience of working with clients. For more information about the Counselling Service, please see our website

Full name: ......

Address: ......

...... Post Code: ......

E-mail address:......

Telephone number: ...... Mobile number: ......

In response to the following questions please expand or continue on another sheet if necessary.

Please tell us why you would like to volunteer as a counsellor for Age UK?

Please give full details (name of course, type of counselling, training provider,completion dates) of your counselling qualification or the counselling course you are currently studying? Is your training course accredited by the BACP (It does need to be)

What year of study are you in? (or,if qualified, please indicate date of qualification)

How many hours of supervised counselling experience do you have and where have these been gained? (Please do not include non-placement counselling hours gained as part of training course)

Please describe the types of client you have worked with?

Do you have any other experience that might be relevant to working with older people as a counsellor at Age UK Brighton and Hove?

Do you have any experience of managing a caseload/workload and maintaining timely and accurate records?

Are you a member of the BACP? (please indicate)yes/no

If yes, please provide your membership number

If qualified, are you a ‘Registered’ member of BACP?yes/no

If so, please provide your Registration number:

AVAILABILITY

The time demands on counsellors are significant. You will need to have approximately4½ to 5 daytime hours available each week to allow for 3 client sessions and travelling in between. This may be able to be split over two or more days.

You also need to attend group supervision on alternate Tuesdays, either from 11:00 to 13:00 or 13:45 to 15:45. In addition, every 6-8 weeks or so, there is a whole team meeting from 12:40 to 13:40 on Tuesdays. There are also occasional Saturday half-day training sessions.

Some benefits for you are that you will receive first class group supervision to BACP standards, and the support of the Counselling Manager and senior management of Age UK Brighton & Hove. There is the opportunity to see clients for up to 18 sessions and to build up your counselling experience with a fascinating and diverse client group, and relevant training is provided.

I confirm I am available for fortnightly supervision on Tuesdays.
Please indicate below your availability for Tuesday mornings or afternoons
Morning yes/no
Afternoon yes/no
Both yes
I am willing to volunteer for a minimum of one year
The weekday(s) on which I could offer counselling are (between 9.30 – 4.30 only please)
Note: It won’t be possible for you to limit your availability for counselling hours to Tuesdays only because of the commitment to attend Age UK B & H supervision:

References – Please give name and address of referees below

  • It is important we receive two satisfactory references.
  • Please ensure at least one referee is not a personal friend or family member. Consider using former employers, teachers, or independent people who can give a view on your experience or character.
  • Please indicate the referee’s relationship to you (in what capacity do they know you)?

1. Name: / 2. Name:
Address: / Address:
Postcode: / Postcode:
Telephone: / Telephone:
E-mail: / E-mail:
Relationship to you: / Relationship to you:

Do you have any access requirements (e.g. large print / wheelchair access)?

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......

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Under the rehabilitation of offenders Act 1974, do you have any unspent criminal convictions? Yes / No

If yes we will ask you about this at the interview

We will carry out DBS check on all volunteers

I CONFIRM THAT I HAVE NOT STATED ANYTHING IN MY APPLICATION FORM THAT I KNOW TO BE FALSE.

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