← Back Trainee Counsellors Application Your details First Name * Last Name * Business Telephone NumberTrainee counsellors, this is optional and will not be shared with clients. 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 placement University *Please provide the name of the university where you are currently enrolled on your counselling or counselling psychology training programme. What is the name of your programme and your expected qualification date? * University Email Address *Please provide your university email address, if applicable. This will only be used to verify your enrolment and for administrative purposes. What is your HCPC student registration number? * University Clinical Placement Tutor (Contact Name) *Please provide the name of your university clinical placement tutor. University Clinical Placement Tutor (Email Address) *Please provide the email address for your university supervisor. External Clinical Supervisor (Supervising Counselling Psychologist) *Please provide the full name of your external clinical supervisor. External Clinical Supervisor Email Address *Please provide the email address of your external clinical supervisor (Supervising Counselling Psychologist). Placement Capacity (Supervisor Approval Required)Please indicate your current approved or requested counselling capacity for this placement. This will be confirmed with your university supervisor before client allocation. 1 client (15 hours total) 2 clients (30 hours total) 3 clients (45 hours total) 4 clients (60 hours total) 5 clients (75 hours total) 6 clients (90 hours total) Are you required by your university or training provider to audio record counselling sessions for training or assessment purposes? * Yes No Who is your insurance provider? * When does your policy start? * When does your policy expire? * 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.