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Placement Application

Are you a member of a professional body such as UKCP or BCAP? Please provide more details here

First Name

Last Name

Phone

Street Address

Street Address Line 2

City

Postal Code

Do you consider that you have a disability or a learning need that we can support you with?

If yes please provide details below:

Are you a member of a professional body under training membership such as UKCP or BCAP?

Please provide more details here

Select your preference of Placement

Please check your availability (you can check more than one box):

Gosforth Clinic - Tuesday Mornings - 10am - 1pm

Gosforth Clinic - Wednesday Evening - 5:30pm - 8:30pm

School - Tuesday Mornings

School - Tuesday Afternoons

School - Thursday Mornings

School - Thursday Afternoons

School - Friday Mornings

Personal Statement:

Please write a supporting statement detailing why you think you would be suitable as a volunteer, with as much detail about yourself and experience as you can including where you are studying and if you green light to practice or when you imagine this would be.

Please be ready to complete as you cannot return to this page or save.

Where did you hear about us?

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Placement Application

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Gosforth Clinic

Monkseaton Clinic