References Form

Thank you for agreeing to provide a reference for an applicant to the Bowlby Centre's four year part time psychotherapy training course.

Information about The Bowlby Centre and the training course is available on our website www.thebowlbycentre.org.uk for your use in responding to this request.

Name of the applicant for whom you are supplying a reference. *

Your Details

Your Name *

Your Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Your Job Title

About the applicant

How long you have known the applicant?

In what capacity do you know the applicant?

Please comment on the applicant’s suitability for the course, supporting this from your knowledge and experience of them?

Any other information that you would like to give to support the applicant and which is relevant to their being able to participate in The Bowlby Centre’s four year psychotherapy training.

Please tick this box in confirmation that it contains accurate and factual information. *

I confirm

Date *

Thank you for agreeing to provide a reference for an applicant to the Bowlby Centre's four year part time psychotherapy training course.

Your Details

About the applicant

Thank you. on behalf of The Bowlby Centre Clinical Training Committee