College of Education, Health and Human Development Application for Entry into Limited Entry Master of Counselling Programme for 2018

Applications must be received by 1 October 2017. Please fill out all of the information below, including the personal statement, and provide the required documentation for your application. Enrolment in each course is limited to 12 students per year. Following your application, eligible students will be selected for an interview and must be eligible to enrol in the Master of Counselling programme.

You must attach the following supporting documentation: 1. Certified copies of academic transcript (Continuing UC students will not need to provide an academic transcript). 2. Details of your work history as a counsellor (must be verified by an employer or supervisor)

You are also required to provide two referee reports – these are completed electronically using the following link: http://tinyurl.com/jageusu

Once you have completed the application form, please email it, along with your supporting documentation, to [email protected] and our Programme Entry Team will begin processing it for you. You may also be required to send hard copies of your transcript- we will notify you if this is required.

Once you have emailed your information, you will also need to complete the online application process. Go to http://www.canterbury.ac.nz/future-students/apply-and-enrol/ and follow the steps to enrol in the programme (please note, you will not be able to add your courses at this time – that will happen once we have completed the interview and selection process.

Section 1: Student to complete: Full Name Date Preferred Name Student Number (If previously enrolled at UC). Qualification First year enrolled in Proposed end date programme Email Address

Home Address Phone Number Mobile Number

Please state the basis of your application:

University of Canterbury. Private Bag 4800, Christchurch 8020, New Zealand. www.canterbury.ac.nz Current Employment:

Position: Full/ Part time: Organisation: Phone: Name and Address of Can we phone administrative head OR this person to YES NO supervisor: inquire about your work there? Work history/ Qualifications: Qualifications: Please list all relevant educational and professional qualifications obtained, including dates.

Previous counsellor training: Include details on where you trained, dates, duration, the name of your trainers and the qualification gained.

Counselling or Counselling Related Employment History:

What work (paid or voluntary) have you been engaged in? Please do not include brief positions. Indicate hours or days per week, length of time employed, whether supervised, total hours of one-to-one and whether you were involved in group/ family counselling.

Supervisor name/ contact Hours Supervised or number. Role held Dates worked Unsupervised Note: this person may be contacted.

University of Canterbury. Private Bag 4800, Christchurch 8020, New Zealand. www.canterbury.ac.nz Future Employment Plans:

What are your employment plans on completion of this course?

How will our Counselling Courses assist you in your future career goals?

Have you ever had formal complaints made about your teaching or counselling YES NO work?

If yes, please provide details:

Have you ever had any criminal convictions or been subject of a negotiated agreement with the Human Rights Commission? YES NO Note: A criminal conviction or negotiated human rights agreement during the course of training will result in your enrolment being reviewed and could lead to termination of your enrolment.

If yes, please provide details:

University of Canterbury. Private Bag 4800, Christchurch 8020, New Zealand. www.canterbury.ac.nz Personal Statement – please answer the following questions: 1. What specific skills and/or topics of interest are you hoping to develop or explore while doing counsellor training?

2. How effective do you judge yourself to be in interacting with other people (clients and/or working colleagues)? On what information do you base your judgement?

3. What adjustments to your current circumstances do you expect to have to make in order to be on this course?

University of Canterbury. Private Bag 4800, Christchurch 8020, New Zealand. www.canterbury.ac.nz Please send the link to the referee report to two people who know Referee Statements: you and your counselling work well, and who would be in a position to comment on your suitability for this training course. We are seeking information about your potential and present ability as a counsellor. Write the names of your two referees below. Unless you specifically state otherwise, we reserve the right to contact your named referees to discuss your application with them.

Please send your nominated referees this link to the online referee report http://tinyurl.com/jageusu

Referee One Referee Two

Name: Name:

Position: Position:

Phone: Phone:

Email: Email:

Please Note: Please be aware the information provided in this application will only be used to determine your entry into COUN675, COUN676 and COUN672. For successful applicants, this information will be used for purposes related to your study in the Master of Counselling programme, in accordance with the Privacy Act 1993.

By signing this document, you are verifying the information provided; including the attached documentation is correct and complete. Please be aware, incorrect or incomplete information may result in your termination from the programme.

Applicants are required to consent to a Police check of their record prior to confirmation of enrolment in the limited entry counselling papers. The police vetting request and consent form will be completed as part of the interview process, should you be successful in reaching this stage.

Interviews Interviews will be held on Monday 6 November and Tuesday 7 November. Please indicate your preferred interview date (please note your interview date will be confirmed once applications close and initial assessment has taken place):

Monday, 6 November Tuesday 7 November

Applicant’s signature: Date:

University of Canterbury. Private Bag 4800, Christchurch 8020, New Zealand. www.canterbury.ac.nz