SPTI Course Application Form

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Application Guidance Notes The Sherwood Psychotherapy Training Institute Further information regarding the application process is available from our SPTI website via this link http://spti.net/training/application.shtml Applicants are welcome to hand write or type the enclosed application form and you should ensure that all sections are completed in full and that you sign and date the declarations in section 16. Your form must be returned with your official signature. SPTI will accept an electronic paste of your signature, or you are welcome to hand sign the form. You should then submit a scanned copy of your application via email to admissions@spti.net and/or print and return your completed application directly to us at: Admissions, The Sherwood Psychotherapy Training Institute, Thiskney House, 2 St James's Terrace, Nottingham, NG1 6FW 1. Data Protection You (the applicant) are advised that by submitting this application form, you are consenting to SPTI (The Sherwood Psychotherapy Training Institute) to use the information you have provided along with any subsequent information (including email/enrolment forms/ documentation from the student handbook) for purposes laid out within the Student Privacy Statement (attached for reference). We will use the personal information you provide to us (including where necessary sensitive personal information relating to your race or ethnic origin, political opinions or religious beliefs, physical or mental health or condition, sexual history or orientation, commission or alleged commission of any offence and any related court proceedings (in order to access DBS checks necessary for counselling work with vulnerable adults (students on placement)): for enrolment and assessment purposes, equal opportunities and diversity monitoringstatistical analysis of student demographics, access to student finance, annual audit of finances required as part of course designation process, allocation of resources (e.g. disability information to make reasonable adjustments and for bursary applications); to supply the Programme to you; to process your payment for the Programme; and to give you information about similar training opportunities and workshops that we provide, but you may stop receiving this at any time by contacting us. We may share your personal information, including sensitive personal information, with HESA (subject to the terms of the HESA student collection notice at https://www.hesa.ac.uk/about/regulation/data-protection/notices) and Student Finance England (subject to the terms of the Student Finance data processing information at http://www.slc.co.uk/students/student-finance-england/dataprotection.aspx), with validating bodies such as Staffordshire University (subject to the terms of the Staffordshire University privacy statement notice at http://www.staffs.ac.uk/legal/privacy/ ) and with East Midland Shared Services (DBS Umbrella organisation) http://emss.org.uk/privacy-notice/ We will only give your personal information and sensitive personal information to other third parties where the law either requires or allows us to do so. Page 1 of 10

2. Applying to a course at The Sherwood Institute Selection is via application form, references and a personal interview. If you have chosen a training programme and wish to make an application, you will need: One Application Form which includes the SPTI Equal Opportunities Monitoring Form http://spti.net/downloads/forms/a01_spti_af.pdf Two Reference Request Forms http://spti.net/downloads/forms/spti-referenceform.pdf If you are applying for the Foundation Access Course, a course-specific reference is required http://spti.net/downloads/forms/a02_fac_spti_ref_form.pdf In the case of potential APL's (Accredited prior learning), please refer to the http://spti.net/training/part-way.shtm for further guidance. We also recommend that you book onto an information day to meet with the Programme Leader and to discuss your circumstances. The information listed below detailing how the admissions process works, forms part of the formal SPTI Admissions Policy. A copy of the full policy can be downloaded via the following link http://spti.net/downloads/documents/spti_admissions_policy_feb2016%20final.pdf Full Legal Name Your full legal name is required (including all middle names) as this is used to register you with SPTI and also the validating University for BSc & MSc students. This name must match your official identity documentation e.g. Passport / Birth certificate. Any subsequent changes to your legal name must be evidenced by official documentation such as a marriage certificate or deed poll change of name. Reference Request Forms Forms will need to be completed by each of your two referees, and returned to admissions. They should be submitted with the separate reference letter, produced where possible on company headed paper. Obtaining and ensuring references are received is the responsibility of the applicant. DBS Checks (Disclosure and Barring Service - formerly CRB checking) - All MSc and BSc students are required to undertake a DBS check at enrolment ( 59) and also to register for the Annual Update Service (currently 13 annually). Criminal Convictions The SPTI application form requires students to declare if they have been convicted, cautioned, bound over or if applicants have a conviction pending in any respect of a criminal offence. If your answer is yes, then you are also required to complete the SPTI declaration proforma. SPTI DBS01 Declaration Proforma (to be returned with the completed Application Form) http://spti.net/downloads/forms/dbs01_spti_declaration_proforma_v2.pdf SPTI Statement on the Recruitment of students declaring a relevant criminal conviction http://spti.net/downloads/documents/spti_dbs_policy_statement_recruitmentv02_feb1 5_FINAL.pdf SPTI Policy and Procedure on the Monitoring of Criminal Records of Trainees http://spti.net/downloads/documents/spti_dbs_policy_applicant%20copy_feb2015_fin AL.pdf Page 2 of 10

Application Deadlines Applications are processed on a first come, first served basis, therefore early applications are advised to avoid disappointment. Applicants should contact the Admissions Office in the first instance to confirm places are still available. Application Processing Timescales We aim to respond to all applications within one month of receipt, if not sooner. In cases where this is not possible, applicants will be informed accordingly. Interviews Interviews are offered for all programmes with the exception of the ABC Counselling Concepts course. For applicants selected for interview, the interviews usually last between 30-45 minutes and are usually with the programme leader. The nature of psychotherapy training is primarily relational and as such it is important for applicants to disclose any pre-existing relationships with SPTI staff and/or members (and other applicants where known) at the point of application and interview. This provides the opportunity to address any potential implications for this at the interview stage and we aim to ensure that this does not provide an unnecessary barrier to recruitment. In cases of preexisting relationships, adjustments may be suggested which could include an alternative entry point or in some cases an alternative programme of study. During the interview, you will be asked to confirm if you have any criminal convictions. Offers Offers are made following successful interview. Applicants to SPTI clinical training programmes (BSc & MSc) are reminded that all offers are subject to a satisfactory criminal record check by obtaining an adult enhanced DBS Certificate. Acceptances of offers made are processed on a first come, first served basis. Places are secured on receipt of the required deposit and written acceptance of the offer. Deposits Deposits are required to secure student places. The deposit is non-refundable and is deducted from the tuition fee amount. International Students SPTI is not a UK Home Office registered Sponsor with approval to admit overseas students. We can only consider applications from applicants who satisfy HOME fee residential status criteria e.g. UK/EU/EEA including Switzerland. Formatting Our documents are in available from our website in a PDF format so you will need suitable program to open them. If you already have a PDF reader installed, clicking on the links above will open the documents. You may prefer to right-click and choose save target as to download and save on your computer. You may already have a copy of Adobe Reader. To download a free copy try https://acrobat.adobe.com/us/en/acrobat/pdf-reader.html Alternatively try Foxit Reader, also free http://www.foxitsoftware.com/products/reader/ If you need any more help in making your application, please do not hesitate to contact us. : Page 3 of 10

Section 1: EQUAL OPPORTUNITIES MONITORING Please tick or highlight your chosen course: BSc (Hons) in Counselling & Psychotherapy (BACP) MSc in Integrative Psychotherapy (UKCP) MSc in Person-Centred & Experiential Psychotherapy (UKCP) SPTI Diploma in Clinical Supervision Academic Year of Entry 2018/19 2019/20 The information in section 1 will be detached and stored on your records. It will not be considered as part of your application. It will be used for statistical analysis and information sharing only (see guidance note 1 data protection) Please enter your name below How would you describe ethnicity/race? The classifications below are provided from HESA (Higher Education Statistics Agency). Please tick the appropriate category (If using a word version of this form, you can copy and paste the tick symbol above) White White (10) Gypsy or Traveller (15) Black or Black British Caribbean (21) African (22) Other (29) Asian or Asian British Indian (31) Pakistani (32) Bangladeshi (33) Other Asian (39) Other Other Ethnic background (80) Not Known (90) Mixed White & Black Caribbean (41) White & Black African (42) White & Black Asian (43) Other mixed background (49) Chinese Chinese (34) Other Asian (39) Arab Arab (50) Ethnicity Information Refused Information refused (98) If these categories seem inappropriate or inadequate to you, how would you wish to describe yourself? How would you describe your sexual orientation? Bisexual (01) Gay woman / Lesbian (03) Gay Man (02) Heterosexual (04) Gender Identity Is your gender identity the same as originally assigned to you at birth? Other (05) Information refused (98) Yes (01) No (02) Gender ID Information Refused (98) Would you describe yourself as a practising member of any of the following religions? No Religion (01) Muslim (12) Buddhist (02) Sikh (13) Christian (03) Spiritual (14) Hindu (10) Any other Religion/Belief (80) Jewish (11) Info Refused (98) Do you feel discriminated against in the application procedures for this course? Yes No If Yes, in what way? If necessary, please continue on a separate sheet Page 4 of 10

Section 2: Course Application The Sherwood Psychotherapy Training Institute Please tick or highlight your chosen course & Year of Entry: BSc (Hons) in Counselling & Psychotherapy (BACP accredited) MSc in Integrative Psychotherapy (UKCP) MSc in Person-Centred and Experiential Psychotherapy (UKCP) Diploma in Clinical Supervision (SPTI) Section 3: Personal Information Full Legal Name (Passport/Birth Cert. name) Informal Name Previous names (Any name changes) Address Postcode Home Telephone Email address Academic Year of Entry 2018/19 2019/20 I have enclosed my completed APL (Accredited Prior Learning) form to apply for direct entry into Year 2 Year 3 (Please note: this name will be used for official certificates and must include all middle names) Title (To be used for correspondence, Moodle & email account) (e.g. Dr/Mr/Mrs/Miss/Ms) Mobile Telephone Date of Birth Please confirm your Gender Female Male Other Where did you hear Info Day about us? Date Attended Section 4: Counselling Qualifications (include any courses you have yet to complete) Organisation Name, Address & Postcode Start End Subject Level Grade MM/YY Passed Section 5: Higher Education Qualifications (Level 4 / Undergraduate and above) Organisation Name, Address & Postcode Start End Subject Level Grade MM/YY Passed Page 5 of 10

Section 6: Other Qualifications (School / College / Adult) Organisation Name, Address & Postcode Start MM/YY End MM/YY Subject Level e.g. GCSE, A level, BTech Grade MM/YY Passed Section 7: English Language Qualifications Is English your If English is not your first language please provide Yes No First Language? details of your English Language qualifications English Lang Qual. IELTS TOEFL OTHER (Please specify) Grade/Level/Score Date Passed Section 8: Professional Experience Organisation Name & Address Nature of work Paid / Voluntary Date From Date to Page 6 of 10

Section 9: Other Experience Organisation Name & Address The Sherwood Psychotherapy Training Institute Nature of work Paid / Voluntary Date From Date to Section 10: Have you received counselling or psychotherapy Yes No (If Yes, please provide details) Section 11: Referees We require two supporting references. Please take responsibility for forwarding the Reference Request Form to your chosen referees requesting them to return the completed forms together with letters of reference directly to Admissions as soon as possible. The first reference should ideally be from your current/most recent employer and/or academic institution; Ideally the referee will have known you for at least two years. The second reference can be from another source. Please note that references from family members and friends are not usually acceptable. Both references should be provided on headed paper, be signed by the referee and returned to the Sherwood Institute together with a reference front sheet. References should clearly state the full legal name of the applicant. First Referee Second Referee Name Job Title Organisation Name Job Title Organisation Address Address Relationship to applicant Length of time known Email Telephone Relationship to applicant Length of time known Email Telephone Page 7 of 10

Section 12: Personal Statement a) Please describe your reasons for wanting to embark on this course at this time in your life (Please continue on a separate sheet if necessary) b) Please describe personal strengths and attributes which you believe will assist you in relation to your selected programme of study, together with any personal limitations and/or characteristics you believe may impede you. (Please continue on a separate sheet if necessary) Page 8 of 10

c) Please outline ways in which you believe the psychotherapy/counselling approach you have decided to apply to study relates to your own personality and experience. Do not hesitate to comment on any areas of conflict as well as those of fit. Please note; you are not expected to know a vast amount about the approach, and it is expected that your comments will reflect your current understanding. This question reflects our belief that the fit between the person and the core theoretical approach is important in training. (Please continue on a separate sheet if necessary) Section 13: Disability Do you consider yourself to have a disability and/or learning difficulty? Please tick all that apply (The classifications below are provided from HESA (Higher Education Statistics Agency). No If no known disability, proceed to section 14 00 Yes If yes please tick any of the following that apply and include further information below A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D 51 A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder 53 A long-standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy 54 A mental health condition, such as depression, schizophrenia or anxiety disorder 55 A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches 56 Please tick if unable to use stairs You are Deaf or a have a serious hearing impairment 57 You are Blind or have a serious visual impairment uncorrected by glasses 58 A disability, impairment or medical condition that is not listed above. Please provide more information 96 below, or on a separate sheet Further information: Have you undertaken a formal assessment? Please tick. Yes No (This may be requested if successful at interview to support reasonable adjustments) SPTI applies annually to HEFCE for Specific Course Designation for MSc and BSc programmes. If awarded this means that DSA (Disabled Students Allowance) support is available to students with qualifying disabilities See our FAQ s for more Information). More details can be found here: https://www.gov.uk/disabledstudents-allowances-dsas/how-to-claim Page 9 of 10

Section 14: Nationality / Residency Country of Birth Legal Nationality Do you have a UK Passport? Yes No If no, which country issued your passport? The Sherwood Psychotherapy Training Institute Country of permanent residence Do you have the right to reside (live) in the UK without restriction? Have you been ordinarily resident in the UK/EU/EEA for the past three years for the purpose other than study? If no, please list the countries you have lived in. How do you intend to finance your tuition fees? Please include copies of all non-uk passports (front as well as the photo ID page) Yes No Yes No Self-Financing Student Loan (subject to HEFCE course designation approval for 2018-19) Professional Career Development Loan (PCDL) Employer/Sponsor Other (provide details) Section 15: Criminal Convictions (Including DBS - Disclosure & Barring Service - formerly CRB) Have you ever been convicted, cautioned, bound over or do you have a conviction pending in any respect of any criminal offence? Yes No If YES: Applicants are required to obtain and complete a separate form DBS01 Written Statement Regarding Declaration of Criminal Convictions. This document forms part of the SPTI CRRP pack and should be requested from the Admissions Office directly or can be downloaded from the Application page of the SPTI website http://www.spti.net/training/application.shtml. This completed form should be submitted in a separate, named, sealed envelope marked Strictly confidential CRRP information - FAO Programme Leader only. Please remember to include the course title. Note: 1. Applicants are advised under the provision of the Rehabilitation of Offenders Act 1974, (Exceptions) Order 1975 and the Police Act 1997 that a person should declare ALL convictions where working with vulnerable adults or children. 2. Disclosure of a criminal record does not automatically debar applicants from consideration. The offence will only be taken into account if it is considered to be one that would make the applicant unsuitable for the type of training for which they have applied. 3. The information provided will be treated as strictly confidential and will be considered only in relation to this application for training. 4. Applicants to our MSc and BSc Psychotherapy and Counselling programmes are advised that they will be required to make a full disclosure during the application and interview process and that SPTI will require them to undertake DBS checks if offered a place. 5. The responsibility to disclose a criminal record rests with the applicant. Applicants who fail to disclose a conviction and whose subsequent DBS check reveals undisclosed convictions, cautions, reprimands and/or warnings may have their offer withdrawn, or their registration terminated. Declarations (Please sign your official signature typed names are not accepted) By signing below, you are declaring that the information included within this application is a true and accurate record Signed: Date: I confirm that I have read the Student Privacy Statement attached to this form and I consent to handling and processing of personal data about me in respect of my application, for admission, as a student if successful and after completion of my course Signed: Date: Page 10 of 10