CHRISTIAN COUNSELLING CENTRE SAINATHAPURAM, VELLORE Application for the one year Diploma in Psychological Counselling. SECTION- I

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CHRISTIAN COUNSELLING CENTRE SAINATHAPURAM, VELLORE Application for the one year Diploma in Psychological Counselling. SECTION- I 1. Name : 2. Address : Pin: 3. Permanent Address : Pin: 4. Birth Place : 5. List the languages you know, and indicate the degree of competency with which you use each language. 6. Religious identity / Denominational affiliation 7. Marital Status No and ages of children 8. Last High School attended : Name Place Date completed Type of Certificate 9. List all institutions attended since High School (Indicate Name, Place, Diploma(s), Certificate and dates completed) 10. Enclosed attested true copies of Degrees, Diploma(s) and / or Certificates(s) and Mark sheets. 11. Describe your present occupation, designation and type of work

Attach a separate sheet listing all previous significant work experience and briefly describe any work of a Counselling or Human Relations Nature (If you have published, include a listing of publications and where they appeared). 12. List special skills you have which are relevant to counselling work. 13. List any special skills or areas of competence on a non-counselling nature which you feel you have. 14. Tell how you learned abut the C.C.C one-year Course: 15. Do you have any other training contracts, if yes, what types: Under whose supervisions: 16. Enclose an endorsement from some one in authority in your Denomination / Organisation / Institution which will assure your employment following your training. (a). Request your immediate supervisor to send under separate cover, an assessment of your suitability for training for professional counselling: DECLARATION: The materials in this application for admission are true and correct to the best of my knowledge. I understand that the falsification of any part of this application is grounds for dismissal. I also understand and accept that this submitted application becomes the property of the Christian Counselling Centre, and is not returnable. Date Signature of the applicant

SECTION II This section of the application is designed to serve two purposes. One is to help us select most promising persons for training in professional counselling, the other is to give you an opportunity to explore for yourself, and share with us those life experiences which have created or contributed to your interest in the field of counselling and psychology, your knowledge and understanding of the helping professions, your plans for and expectations of the future, and your aptitude for solving problems of human living. This section may also give you an idea about some ways in which counselling psychologists seek to understand other people. INSTRUCTIONS: Use separate sheets of papers for each question or contributions of questions. Put your name in the upper right hand corner of each sheet. PART A (LIMIT TO 8 TYPED PAGES) Autobiography Tell us your life up to now. Describe your family, your friends, your home. Review any critical experience which have had major effect on your life, and describe the manner in which you have handled those, elaborate particularly on those experiences that you feel are relevant to your interest in professional counselling and that make you the kind of person who can understand and help others. Use your own discretion and describe some of the important factors in the kind of person you are, which have to do with your cultural background (e.g. attitude towards authority, expressing feelings, attitude towards persons of other provinces and places, etc.) PART B (LIMIT TO 2 PAGES) Describe an ordinary 24 hours in your life. Include your usual activities and describe your home, school, place of work, neighborhood etc., whichever is appropriate. Also describe the important people whom you encounter in the course of your day, telling how they behave toward you and how you feel about them. PART C (LIMIT TO A TOTAL OF 3 PAGES) YOU MAY AMALGAMATE THE QUESTIONS IF YOU LIKE. 1. What do you think is the most interesting problem in counselling & why? 2. What do you want to do as a Professional counsellor? Please be specific.

PART D (LIMIT TO 2 PAGES PER QUESTION) PROBLEM SITUATIONS: 1. Write about a counselling oriented situation that you dealt with effectively? 2. A 30 year old husband begins to talk to you about the tension he is experiencing in his marriage. The husband complains to you about his wife s behavior in the home and with him. What do you think is going on? What would your course of action be? 3. You have been invited by the Priest/Pastor of a semi-urban congregation of 137 families to help in reducing tension existing between two groups in the church. Most of the complaints relate to conflicts, between two men who are of different castes and back grounds. Indicate how you will function in this situation. You have been called in by the Manager of a small factory to serve as a consultant to reduce tension which is destructive to the growth of the firm. The Manager reports that there are conflicts between members of two different communities. Indicate how you would function in this situation. 4. Identify what you think is a single important ingredient of normal child development. Discuss why you think so and ways you see this ingredient effectively encouraged and developed or hindered, in child rearing (for example in home, school and their institution). Developmental psychology can be thought of as a way of looking at general processes and areas of functioning across the life span. Select a problem of interest to you that might be productively approached from this point of view and discuss it. 5. A boy in the fourth grade is very hostile, destructive, and prone to getting into fights, speaking out of turn and using foul language to the teacher. You, as a School Counsellor, are called in to contact the family. How would you go about this and how would you deal with the teacher, the boy and the parents?

PART E (LIMIT TO 1 PAGE) As you look back over this application that you have filled out, were there any areas difficult for you. How did you handle them? BEFORE YOU SEND IN YOUR APPLICATION Check carefully to see that all questions have been answered and all information is enclosed with the application. ***********************************