SHEP Facilitating Groupwork, Kilkenny

Your name:

Address:

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Contact Phone Number(s):

How did you hear about this programme: (optional)

Please describe any additional supports you may need to complete this course:

Do you have any medical condition that we should be aware of?

In case of emergency what Number should we contact?:

Signature of Applicant and date required (Please take photo of your signature and current date and upload here please.):

Application Part 2: REFLECTIVE WRITING
Places will be allocated based on the quality of reflection in this section and date order of applications (A minimum of 400 words is expected. Max 800 words)

1. Outline your current employment and/or voluntary status and role (Max 150 words):

2.Reflect briefly on your work-life journey which has brought you to where you are now.
(Max 150 words):

3.Why do you want to participate on this programme?

4.Have you done group-work before? If so, what was that experience like?

5.Anything else you would like to add to support this application? (Max 150 words):

I have read SHEPs privacy guidelines

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