EmailMe Form - Linden Anxiety Recovery Course Application Form

Please note, if you haven't already received the LAR Coaching Information regarding the course and coaching in practice, please email beth@thelindencentre.org prior to completing this application. Thank you.

Guidance on Completing This Application:

Please complete this application to the best of your ability. All information is held in confidence and will not be shared with any third parties.

Any queries, contact beth@thelindencentre.org
Many thanks.

STORAGE OF YOUR PERSONAL INFORMATION
Upon hitting submit, your completed questionnaire is emailed to Beth at The Linden Centre. Once reviewed it will be deleted from the computer and printed and retained securely.

If you decide to commence the course, you will be required to sign a Licence Agreement and all the necessary paperwork will be sent to you by Beth once your application has been successful. Please note that following successful application, a one hour
interview via Zoom
will be conducted.

Controlling your personal information:
As the subject of personal data held about you, you have:

● The right to be informed
● The right of access
● The right to rectification
● The right to erasure
● The right to restrict processing
● The right to data portability
● The right to object
● Rights in relation to automated decision making and profiling.

You may request details of personal information which we hold about you. If you would like a copy of the information held about you in the future, please contact julie@thelindencentre.or to request a subject access request form.
THANK YOU.

Your Personal Details

Full name *

Email *

Confirm

Mobile Phone Number Including Country and Area Code

ADDRESS:

Native Language

Gender

Male

Female

Non-Binary

Date of Birth *

MM / DD / YYYY

English Language Qualification - If your first language is not English please give details of the most recent English Proficiency course you have taken.

Disabilities/Special Needs

For monitoring Equal Opportunities, please describe your Ethnic Origin:

White

Mixed/Multiple

Black/African/Caribbean/Black British

Other eEthnic Group

School Education

School Name *

Graduation Date

MM / YYYY

School Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

List Qualifications Awarded *

University/College

University/College Name

Graduation Date

DD / MM / YYYY

University Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

List Qualifications Awarded

Extracurricular, Personal and Volunteer Activities

Talents and Awards:

List each, a description, the level, and number of years of involvement.

Extracurricular Activities:

List your organizations, position, description of the activity, and hours per week of involvement.

Life Experience & Employment

Have you ever suffered from an anxiety disorder? *

Have you yourself used The Linden Method programme to treat your own anxiety? If so, please give the year that you became a Member. *

It is vital that your priority is YOUR recovery. If you are still suffering but are well on your way to full recovery, how would you rate your level of anxiety currently on a scale of 1-10. (10 being fully recovered). *

Employment: *

List the job, your title, description, hours per week, and dates of employment.

Relevant Experience

List any work you have carried out in the caring or healthcare professions

Please tell us, in not less than 200 words, what is
your motivation for becoming a Linden Anxiety Recovery Coach? *

How many hours would you ideally like to commit to your coaching services per week (to include marketing)? *

What are your current work commitments and how do you see LAR Coaching fitting into your current schedule? *

Additional notes or comments

I have checked these details are correct. I understand and agree to Linden Coaching Accreditation using this and other data to create and maintain records on me and for statistical purposes in accordance with GDPR 2018. I agree that this information will be kept for the duration of the recruitment process and for a period of time thereafter. Should I become a Coach, I agree that this information will be kept for the duration of my involvement and for a period of time following this. I am aware I have the right to request a copy of the data held on me.

Data protection agreement *

I have read and agree to the data protection statement