Professional Development Workshops 2019

EFT Postgraduate Course Application Form

Please fill in the application form below
1. Personal details:
I am a :

New postgraduate student Re-enrolling postgraduate student
New and re-enrolling students, please select your postgraduate course:

Graduate Certificate in Emotion Focused Therapy Graduate Diploma of Emotion Focused Therapy
Name: *

First Name Last Name
Student number (if re –enrolling):
Birth Date: *

Month Day Year
E-mail Address: *
example@example.com
Mobile number: *
Work number:

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State

Post code
Where did you hear about BIA EFT courses

2. Qualifications and professional experience
List all tertiary qualifications or equivalent:
Highest Level of qualification on entry: *
Year of graduation

Month Day Year
Date
Current role:
Practice/organisation:
Number of sessions per week:
Counselling
Therapy
Supervision
Work address:
Please provide details of relevant counselling and/or therapy experience:
List your professional association memberships (or eligibility to join):
What are your reasons for applying for this course ?
Do you have any learning needs:

Yes No
If yes, please provide a summary of your learning needs:
Please attach certified copies of all testamurs and transcripts for qualifications and a proof of ID (birth certificate ,passport or driver's license ). *

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Please upload your National police check . This can be obtained from Australia post . https://auspost.com.au/police-checks

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Promotion code
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EFT Postgraduate Course Application Form