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Application Form
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Please complete the form below to apply for our courses.
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Start date
Spring
Autumn
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How did you hear about us?
e.g. friend, Weibo, Wechat
Personal Details
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Full Name
Title
Title
First Name
First Name
Last Name
Last Name
*
Date of birth
*
Age
*
Current Address
Address Line 1
Address Line 1
Address Line 2
Address Line 2
City
City
Province
Province
Post Code
Post Code
*
Mobile Number
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Email Address
Country of birth
Education
Your previous education
Part 1
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What is the highest level of education you have completed so far?
Please choose
PhD
Masters Degree
Postgraduate Degree
Graduate/Bachelor's Degree
No Formal Education
Other
If other, please specify
*
Subject name
*
Year of Completion
Part 2
Counselling training (if applicable)
Please choose
Certificate (Foundation/Level3)
Qualified Counsellor/Therapist
Name of institution
Course title
Year of Completion
If other, please specify
Part 3
Additional qualification (if applicable)
Please choose
PhD
Masters Degree
Postgraduate Degree
Graduate/Bachelor's Degree
No Formal Education
Other
If other, please specify
Subject name
Year of Completion
Employment
Current and previous employment
*
Name of employer (1)
*
Position held (1)
*
Start Date (1)
*
End Date (1)
*
Reason for leaving (1)
Name of employer (2)
Position held (2)
Start Date (2)
End Date (2)
Reason for leaving (2)
Name of employer (3)
Position held (3)
Start Date (3)
End Date (3)
Reason for leaving (3)
Equal Opportunities
Please list any physical or sensory disabilities that might affect your studies.
Do you require support facilities or additional support from CPPD & WENSU?
Disclosure
*
Have you ever been disqualified from any professional organisation? If none, please write 'none'.
*
Do you have any criminal offences, either spent or unspent? If none, please write 'none'.
Declaration
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By signing full name you agree to the following declaration:
I hereby declare that, by submitting this form to CPPD & WENSU, all of the the information I have provided is, to the best of my knowledge, correct and truthful.
Last Name + First Name (e.g. ZHANG SAN)
Evaluation object score
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