Student Counsellor Placement Application

Please answer each question in full and in your own words. Applications that appear to be AI-generated will not be progressed, and only fully completed applications can be considered.

Your answers and CV are encrypted in your browser before they are sent, and can only be read by our team. Fields marked * are required.

Full name *

Email address *

Phone number *

Preferred pronoun *

Are you an experienced student counsellor, or seeking your first placement? *

ExperiencedFirst placement

Name of educational institution, course title, level of study, and modality *

Total client hours you need to achieve, and how many you have completed so far *

Why do you want to become a counsellor? Please tell us a bit about yourself *

What attracted you to this placement opportunity? *

An 18-year-old client discloses during a session that they are being hurt at home, but begs you not to tell anyone. How would you respond? *

You are on placement and receive a phone call from someone saying they are from the Police, asking you to share information about your client in relation to an active investigation. How would you respond? *

Are there any presenting issues or types of client that you feel you could not work with? *

Do you have previous experience in counselling, mental health, or similar fields? *

Do you have any access needs or adjustments we should be aware of to support you during an interview or placement? (optional)

Which of these do you already have in place? Tick all that apply.

Your CV * (PDF or Word, up to 8 MB)

I confirm this application is my own work, written in my own words. *I consent to Empathy Northwest CIC processing the information in this application, including my CV, to consider me for a placement. I understand it is handled as set out in the Privacy Policy. *