Post Graduate Diploma in Supervision in Ireland

Post Graduate Diploma in Supervision

*Required

Personal Details

Name: *

E-Mail: *

Address: *

Phone No.: *

Counselling /Psychotherapy / Professional Qualifications: *
(please add date attained & name of training institute)

Date accreditation to professional body: *

Training & /or experience of providing supervision: *

Your supervision role at work: *

Your experience of receiving supervison: *

Please indicate why you wish to be considered for this course: *
(about 200 words)

Referees

Please supply the names and addresses of two referees, who must not be relatives

Referee Name: *

Address: *

Position: *

Referee Name: *

Address: *

Position: *

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in the image: *
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