See Beyond Counselor/Therapist Application Form We are happy to receive applications from both those "new to the field" as well as "established professionals." Name * First Name Last Name Email Address * What is your nationality and what place feels most like "home" to you? Where do you live most of the year? * What is your address in your "home" country? * I understand that if I am hired, * I will get paid in dollars (not local currency). This job does not provide for residency at this time (or in the foreseeable future). I will be an independent contractor and not an employee unless clearly stated in my contract. Ideally, what type of counseling would you like to provide, or what niche group would you like to provide it to? * What would it mean to you to work with See Beyond in this capacity? * Please rate your abilities in the following areas: Organization * Excellent Good Fair Not so good Don't count on me for this! Interpersonal skills * Excellent Good Fair Not so good Don't count on me for this! Ability to get along with computers and technology * Excellent Good Fair Not so good Don't count on me for this! Ability to come up with creative solutions * Excellent Good Fair Not so good Don't count on me for this! Ability to keep things confidential * Excellent Good Fair Not so good Don't count on me for this! Ability to lead others * Excellent Good Fair Not so good Don't count on me for this! Flexibility * Excellent Good Fair Not so good Don't count on me for this! Ability to train others (facilitate seminars, for example) * Excellent Good Fair Not so good Don't count on me for this! Please describe your strengths and weaknesses in your relationships with others. What interpersonal skills are strong? Which are weak? * What do you consider to be the areas of your counseling that need improvement? * What do you consider to be the strengths of your counseling? * What is your degree title, from what school did you obtain it, and in what year? * Describe your level of licensure. Include the location of your licensing, with website link and licensing number and expiration date. * Do you have current professional liability insurance? * Yes No Have you ever had a malpractice claim filed against you? * Yes No Have you had liability insurance denied, suspended, or revoked? * Yes No Do you know of any complaints currently pending against you that might result in an insurance claim? * Yes No What is your theoretical approach(es) to counseling and why? * What specialized training have you received? Please note name, dates, and any license or certification that was included. How many years have you actively been counseling on a full-time/part-time basis? If less than 5 years full-time, please share the number of counseling hours obtained, excluding practicum and internship hours. * Please list the name, location, and duration of your professional work experience in this field. List your publications, teaching experience, conference and/or workshop presentations you've done. List your professional association memberships. Are you currently under supervision? * Yes No Have you been reported for any ethics violations? If so, please describe. Please provide your social media name/links: Language Fluency English Native or near native Excellent / Professional level Good command I can make myself understood Little to no understanding Local Arabic Native or near native Excellent / Professional level Good command I can make myself understood Little to no understanding Classical Arabic Native or near native Excellent / Professional level Good command I can make myself understood Little to no understanding French Native or near native Excellent / Professional level Good command I can make myself understood Little to no understanding Spanish Native or near native Excellent / Professional level Good command I can make myself understood Little to no understanding Korean Native or near native Excellent / Professional level Good command I can make myself understood Little to no understanding Other (rate and then mention in comments box) Native or near native Excellent / Professional level Good command I can make myself understood Little to no understanding Comments or Questions Finally, please provide 6 references. Include at least one previous employer, one clinical supervisor (or someone who has observed your counseling), 2 co-workers, and one or more people you have helped (clients or those you've helped process things outside of counseling). You can see the reference form I'll ask them to fill out. We do ask your references for secondary reference contact information. In addition to these references, we may ask those in your community their assessment of your reputation and character. Counselor Application Reference Form Reference 1 Name * First Name Last Name Reference 1 Email * How do you know this reference / to which aspect of your character or work abilities are they especially able to speak? * Reference 2 Name * First Name Last Name Reference 2 Email * How do you know this reference / to which aspect of your character or work abilities are they especially able to speak? * Reference 3 Name * First Name Last Name Reference 3 Email * How do you know this reference / to which aspect of your character or work abilities are they especially able to speak? * Reference 4 Name * First Name Last Name Reference 4 Email * How do you know this reference / to which aspect of your character or work abilities are they especially able to speak? * Reference 5 Name * First Name Last Name Reference 5 Email * How do you know this reference / to which aspect of your character or work abilities are they especially able to speak? * Reference 6 Name * First Name Last Name Reference 6 Email * How do you know this reference / to which aspect of your character or work abilities are they especially able to speak? * Please send your send your CV, license certificate, liability insurance to katherine@seebeyond.cc Sent or Will send after submission Forthcoming Thank you!
