← Back Your details First Name * Last Name * Business Telephone Number *Qualified counsellors, please provide your business number. Business Email *This email will be shared with clients. Please use a dedicated professional email — not a personal address. Business or Practice Name * Website * Your practice Please provide a short professional profile (maximum 90 words) *Write in the third person. This will be published on the TMAF website to help clients learn about you. Include your training, therapeutic approach and areas of interest. Counselling Modality *Please specify the therapeutic approach(es) you are trained in or currently practising (e.g., CBT, person-centred, psychodynamic). Clinical Specialisms *Which clinical specialisms do you have experience working with? Please select all that apply ADHD / Neurodiversity Autism spectrum conditions Anxiety disorders Depression / low mood Trauma PTSD Bereavement / grief Relationship / couples issues LGBTQIA+ clients Domestic abuse Eating disorders Self-harm Suicidality Addiction / substance use Personality disorders Work-related stress / burnout Student mental health Cultural / identity issues None of the above / general practice Other If you selected Other above please specify * How do you deliver sessions? * Online only In person Telephone only A mix of the above Your qualifications What is your professional body registration number? *Please include the name of the professional body e.g. BACP 123456 / HCPC 123456 Please list any professional memberships you hold, including the name of the organisation and the dates of membership. * How many years of post-qualification experience do you have? 1 year 2 years 3 years 4 years More than 5 years Tell us more Why do you want to work with the TMAF Counselling Sponsorship Scheme? *Please tell us what draws you to working with Black women and why you would like to join the scheme What do you feel you bring to this role and to the women you will be working with?This could include personal values, lived experience, professional background or cultural awareness Is there anything else you would like us to know about your application? ConfirmationBefore you submit please confirm the following: (1) all information provided in this application is true, complete and accurate; (2) you understand that if accepted onto the scheme you will be required to complete a registration form and sign a formal agreement before any clients are allocated; (3) you consent to TMAF storing your application information securely for the purposes of processing your application. I confirm all of the above * Electronic Signature (Full Name) *Typing your full name below constitutes your electronic signature and confirms that you have read, understood, and agree to all terms of this agreement. Qualified Counsellor Application