Fundamentals of Psychoanalytic Thought and Practice Application Form

Name *

First

Last

Address *

Address Line 1

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City

State / Province / Region

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Email *

Phone

Academic year applied for *

The academic year starts in September, please state which year you would like to begin your training.

Course/s applied for *

Classical Freudian Theory
Work Discussion Group
Infant Observation
Introduction to Psychoanalytic Theories and Concepts

Please say why you would like to do the course/s for which you are applying, giving brief relevant details of your experience, work and/or interests. *

Do you intend to apply for one of our Clinical Trainings (psychodynamic or psychoanalytic psychotherapy)? *

What knowledge and/or experience do you have of psychoanalytic theories and concepts? *

Please provide details of any personal therapy (you do not have to disclose the name of your therapist). *

Please provide details of education and any professional training *

Please provide details of your work situation and brief details of your work history *

Referees

Referees should have known you personally for a significant period and should not be relatives or friends.

Applicants for Infant Observation should provide details of two referees, one of whom should be someone familiar with your work.
Applicants for Work Discussion and Classical Freudian Theory need only provide details of one referee who is familiar with your work.
References are not required for the Introduction to Psychoanalytic Theories and Concepts course.

Referees will be contacted immediately on receipt of your application so, please forewarn them.

Layout

Referee 1

Referee 2

Training Fee Payment Terms

Deposits for CFT and WDG are due when an offer is made and are non-refundable.
Deposits for Infant Observation are due when an interview is arranged. If the candidate is not offered a place their deposit will be refunded less an administration fee of £60
Course fees must either be paid, or a payment arrangement agreed, prior to the start of the course applied for.
Please note that we are a small organisation offering specialised training and operating on tight margins, and by accepting your place you have entered into a contractual agreement to pay the full amount of fees for the academic year, which will remain due even if you decide not to complete it.
Applicants for Infant Observation are required to attend an interview and if offered a place we ask for an enhanced DBS check (for which an additional fee is payable).
Any offer of a place is subject to satisfactory references.

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Declaration

All the information I have entered in this application form is true and correct.

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