BEREAVEMENT VISITORS APPLICATION FORM

* Indicates required field  
Last Name*
First Name*
Home Address*
Postcode*
Home telephone (020):*
Work telephone:
Can we call you at work? Yes:     No:
Mobile number:
Fax number:
Date of Birth:
Age:*
Do you have a car? Yes:     No:
Have you ever been Police-checked?* Yes:     No:

If so, when and where?*

 

Please answer the following 5 questions

1. Why are you interested in helping the bereaved? *

2. Have you had a major loss within the last two years?
    (redundancy/bereavement/divorce/major illness)*

3. What other events or experiences have been important to you?*

4. What are your current weekly commitments? (Work, college or other)*

5. Please give details of training, qualifications and/or experience. Give names
    of schools, colleges, universities and type of approach, if you are studying on
    Counselling courses.*

 

Please give 2 references

Personal Reference
(Not tutor or employer)

Name: *

Address: *    

Postal Code: *

 

Professional Reference
(Tutor or employer)

Name: *

Address: *    

Postal Code: *

 

 

 

Upon assessment of the information you have given in this application form, you may be invited to join a training course at the end of which you will be offered an interview with the BBS
Co-ordinator.

Completion of this course will not guarantee a placement with the Services.

 

Thank you

BBS email address: brentbs@btinternet.com