Training One

Professional Application

From time to time vacancies occur within our National Support structure.

To indicate an interest in becoming an OCP contracted professional please complete and submit the following application form. NB All information will remain completely confidential. * Required

First Name*

Last Name*

Email Address*

Work Phone Number

Home Phone Number*

Cellphone

Postal Address

City

Postcode

Country

Physical Address of your Counselling practice

City

Postcode

Country

2. Number of Years Practicing *

3. Actual Applicable Qualifications: *

4. Your Registered Professional Afflication: *

Do you have Supervision? *

how often?

Fortnightly
Monthly
Other

if "other" please detail:

Your supervisor's name, qualifications and contact details:

6. Have you provided shot/medium term counselling services before? *

7. Do you have training or specialise in any mental health conditions? *

8. Do you have experience or qualifications with drug/alcohol and or gambling issues? *

9. Your last 5 years of counselling experience *

10. Has your Professional Association ever had a complaint about you? *

if Yes, please provide details:

11. Your Professsional Indemnity Cover? *

Referee 1: *

Referee 2: *

13. Is there any further information you would like to add? *

Professional Application

From time to time vacancies occur within our National Support structure.

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