Online Co-Counselling Course: Spring 2021

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The aim of this form is to help you understand why you would like to do this training. Please fill in this form as honestly as you can. All information will be kept confidential by the trainer Kathleen. If there is anything you'd like to discuss you can do so by tel: 00447871955394 or email: cocounselling.training@gmail.com

Email *

1. Which online Co-Counselling Course would you like to do? Both start the week commencing 5th April 2021 and last for 10 weeks. *

Monday evening 7-9pm GMT

Tuesday daytime 11am-1pm GMT

Either

2. Contact Details

Please fill in these details so you can be contacted about the training

Name *

Email address *

Postcode *

Country *

Phone Number *

3. This training is suitable for people who are willing to listen attentively to someone else, as well as willing to receive the attention of others to help with their own life. How do you feel about doing these two things: listening and being heard? *

4. Take a moment to write a little bit about yourself and your life at the moment. What would you like to get out of this co-counselling training and do you have any concerns about participating in this course? *

5. How did you find out about this Co-Counselling course? *

Co-Counselling UK Website http://www.co-counselling.org.uk/

Trainer (Kathleen Cassidy)

Facebook (invite, message, post)

Recommendation from someone trained in co-counselling

Other:

6. What suggested contribution (based on a sliding scale) do you feel you can make towards this course? Please be honest about what you can afford, and take into account your income and if you have any savings. Those who can afford a bit more help subsidise places for those who can't. Thank you. *

£75-(For those who are unemployed)

£105 (For those with annual income of around £10,000 )

£145 (For those with annual income of around £15,000 )

£195 (For those with annual income of around £20,000 )

£245 (For those with annual income of around £25,000 )

£295 (For those with annual income of around £30,000)

Add £10 for every £1000 increase annual income after this

Other

If other, please comment here

7. Are you available to do the whole training? This is a commitment of 3 hours a week for 10 weeks. This is made up of the 2 hour weekly online classes and a 1 hour practice session which you arrange each week with your practice partner at a time to suit you both. *

8. This training will take place online using Zoom. Do you have access to a computer/tablet you can use for the course? It is recommended to use a bigger screen than a phone for the training. *

9. Do you have any specific learning needs/requirements? *

10. Do you have any feedback about this form? Thanks for filling it in. You will be contacted within 1 week of your application.

11. Diversity and Inclusion

Our aim is for co-counselling to be accessible to all. Completing these few optional questions will help with monitoring diversity and inclusion.

Age

Gender

Ethnic Heritage

Sexuality

Occupation

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