Awareness in bereavement care a foundation course

Serving the Area of Kensington, Chelsea, Hammersmith & Fulham

AWARENESS IN BEREAVEMENT CARE

A FOUNDATION COURSE
Spring 2017 APPLICATION FORM

Name:
Address:

Tel no:
email:
Age: 18 – 25 □ 26 – 30 □ 31 – 40 □ 41 – 50 □ 51 – 60 □ over 60□
Occupation:

If you have obtained this application from an online download and prefer to apply by email, please save this document to your computer and send the completed form as an email attachment.

Please do not apply if you have had a significant bereavement in the last two years.

1. 
   Please tell us the reasons why you are interested in bereavement care.
   

2. 
   Please give details of any counselling experience/training or other training which seems appropriate.
   

3. 
   Please provide us with any other information which you feel is relevant to your application for this course and future potential volunteering.
   

 Tick here to confirm that you have read the requirements and responsibilities for Bereavement Volunteers found on our website kchf-cruse.org.uk

 Tick here to confirm you understand that Bereavement Volunteers see clients both at the Cruse North Kensington office as well as in clients’ homes across the boroughs of Kensington, Chelsea, Hammersmith and Fulham
 Tick here if you are looking to train with Cruse as part of a placement required to complete a counselling course or degree

Date: ____________ Signature: _______________

Applications are welcome until the deadline of 7 April, 2017

• 
  By post: Cruse Bereavement Care, 7 Thorpe Close, London W10 5XL
  
• 
  By email: [e-mail] (send the application as an attachment)
  

Registered Charity No. 208078