5th September 2010 

Application for Cascade Diploma


Please ensure you have read the Entry Requirements
before you fill in the application form.

Please complete the following. All fields will extend to accommodate your answers. A copy will be emailed to you when you send this form. Please keep the copy as it will become the basis of your portfolio. Complete the form fully and ensure you meet all the criteria.


Please state which residential course you are applying for (North, South or West):



If this course is full do you have a second choice? Please state:




Name


Address


Contact

Work Telephone:



Home and Mobile Telephone:



e-mail:



How would you describe yourself in terms of origin and background?



Further and Higher Education
Please list the dates of your course/courses, the College/University attended, the title of the course, and the qualification obtained (this field will extend to accommodate all your information):



Professional Training
Please list the dates of your course/courses, the College/University attended, the title of the course, and the qualification obtained (this field will extend to accommodate all your information):



Work Experience (paid and voluntary)
Please list by date, beginning with your current work (this field will extend to accommodate all your information):



Supervising Details
Experience of Supervising and plans to supervise during this course:



What are your supervisory arrangements for your present supervision work if applicable?



Do you have any difficulties or disabilities which you consider we need to know about in order to help you with your learning or your accomodation? Please clarify your needs as much as possible so that can we can do our best to provide appropriate facilities e.g. do you require a bathroom/bedroom with disabled facilities?



Do you know of anyone else who is applying for the course this year?



If you need an agency to be invoiced, please give name and address of agency and probable amount to be invoiced. PLEASE NOTE we will not invoice until we have received your registration form:



How did you find out about this course?



Please bear in mind that we consider a fundamental aspect of this course to be the ongoing engagement of each member with the training and assessment process. In this way we believe we offer a parallel with the realities of practice in the world; we engage in ongoing dialogue with each other; we are in constant relationship and all the responsibilities this entails and we evolve and maintain a community that celebrates difference.

This next section will form an important part of your first piece of work - please take as much space as you need. Describe your reasons for wanting to embark on supervision training at this time in your life, and for choosing CASCADE supervision training in either North, South, or West in particular (this field will extend to accommodate your answer):



When you have filled in all the relevant information above, please sign by typing your full name, enter the date and click Send to submit your form.

Signature



Date



     


Please read the Registration Procedure when you have completed this form.

Please note:
Some people have very high settings on their email spam filters. If you do not get a copy of this form it is probably in your spam. If this occurs you will need to ensure the cascade email is in your address book or all subsequent emails will automatically go into your spam.


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