{"id":29551,"date":"2021-02-08T12:05:22","date_gmt":"2021-02-08T11:05:22","guid":{"rendered":"https:\/\/www.counselling.nl\/questionnaire-for-admission-to-the-training-programme\/"},"modified":"2025-01-22T10:27:59","modified_gmt":"2025-01-22T09:27:59","slug":"questionnaire-for-admission-to-the-training-programme","status":"publish","type":"page","link":"https:\/\/www.counselling.nl\/en\/questionnaire-for-admission-to-the-training-programme\/","title":{"rendered":"Questionnaire for admission to the training programme"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row][vc_column]<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_4' style='display:none'><div id='gf_4' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_4' id='gform_4'  action='\/en\/wp-json\/wp\/v2\/pages\/29551#gf_4' data-formid='4' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6LdSgzkrAAAAALqF3_DVlRxqa-vFUhJEwmxDg-Sg' data-tabindex='0'><input id=\"input_35be03f21148cf7daf00d9edcddf7231\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_35be03f21148cf7daf00d9edcddf7231\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_4_27\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_27' id='input_4_27' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_4_1\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>Questionnaire<\/h2>\nThis questionnaire will only be used to assess whether you can be admitted to the training programme. The data will be processed by ACC staff and will be shared with your teacher.<\/div><div id=\"field_4_42\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Fields with a <font color = \"red\">* <\/font>are required.<\/div><div id=\"field_4_3\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_3'>Preferred training programme<\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_4_3' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_4\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_4'>Preferred starting date<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_4_4' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_63\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_63'>Gewenste startdatum Tweede Spoor Coach<\/label><div class='gfield_description' id='gfield_description_4_63'>Je kunt hieronder aangeven op welk moment je wilt starten met het supervisietraject Tweede Spoor Coach. De supervisor zal contact met je opnemen om concrete afspraken te maken over het traject.<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_63' id='input_4_63' type='text' value='' class='datepicker gform-datepicker dmy_dash datepicker_with_icon gdatepicker_with_icon'   placeholder='dd-mm-yyyy' aria-describedby=\"input_4_63_date_format gfield_description_4_63\" aria-invalid=\"false\" \/>\n                            <span id='input_4_63_date_format' class='screen-reader-text'>DD dash MM dash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_63' class='gform_hidden' value='https:\/\/www.counselling.nl\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_5\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_5'>Preferred location<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_4_5' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_64\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Alternative option(s) training location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_4_64'>The training programme will only be able to start with enough student registrations. In the unlikely event that your group will not be able to start, we will do our very best to offer you an alternative. Below, you can indicate whether you would also like to participate in another group. <a href=\"https:\/\/www.counselling.nl\/en\/trainings\/coaching-and-counselling\/#register\" target=\"_blank\">Click here<\/a> to view the different locations and class schedules.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_64'>\n\t\t\t<div class='gchoice gchoice_4_64_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='I am not able\/willing to participate in another group'  id='choice_4_64_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_4_64\"   \/>\n\t\t\t\t\t<label for='choice_4_64_0' id='label_4_64_0' class='gform-field-label gform-field-label--type-inline'>I am not able\/willing to participate in another group<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_64_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='I can\/want to participate in another group if necessary'  id='choice_4_64_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_64_1' id='label_4_64_1' class='gform-field-label gform-field-label--type-inline'>I can\/want to participate in another group if necessary<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_65\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >At which other locations would you be able\/willing to participate?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_65'><div class='gchoice gchoice_4_65_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.1' type='checkbox'  value='Amsterdam (vrijdag)'  id='choice_4_65_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_65_1' id='label_4_65_1' class='gform-field-label gform-field-label--type-inline'>Amsterdam (vrijdag)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_65_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.2' type='checkbox'  value='Rotterdam (vrijdag)'  id='choice_4_65_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_65_2' id='label_4_65_2' class='gform-field-label gform-field-label--type-inline'>Rotterdam (vrijdag)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_65_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.3' type='checkbox'  value='Utrecht (zaterdag)'  id='choice_4_65_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_65_3' id='label_4_65_3' class='gform-field-label gform-field-label--type-inline'>Utrecht (zaterdag)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_65_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.4' type='checkbox'  value='Online (zaterdag)'  id='choice_4_65_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_65_4' id='label_4_65_4' class='gform-field-label gform-field-label--type-inline'>Online (zaterdag)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_65_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.5' type='checkbox'  value='Ik wil de opleiding eventueel in het Engels volgen'  id='choice_4_65_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_65_5' id='label_4_65_5' class='gform-field-label gform-field-label--type-inline'>Ik wil de opleiding eventueel in het Engels volgen<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_90\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Alternative option(s) training location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_4_90'>The training programme will only be able to start with enough student registrations. In the unlikely event that your group will not be able to start, we will do our very best to offer you an alternative. Below, you can indicate whether you would also like to participate in another group. <a href=\"https:\/\/www.counselling.nl\/en\/trainings\/coaching-and-counselling\/#register\" target=\"_blank\">Click here<\/a> to view the different locations and class schedules.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_90'>\n\t\t\t<div class='gchoice gchoice_4_90_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='I am not able\/willing to participate in another group'  id='choice_4_90_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_4_90\"   \/>\n\t\t\t\t\t<label for='choice_4_90_0' id='label_4_90_0' class='gform-field-label gform-field-label--type-inline'>I am not able\/willing to participate in another group<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_90_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='I can\/want to participate in another group if necessary'  id='choice_4_90_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_90_1' id='label_4_90_1' class='gform-field-label gform-field-label--type-inline'>I can\/want to participate in another group if necessary<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_91\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >At which other locations would you be able\/willing to participate?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_91'><div class='gchoice gchoice_4_91_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.1' type='checkbox'  value='Amsterdam (Saturday)'  id='choice_4_91_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_91_1' id='label_4_91_1' class='gform-field-label gform-field-label--type-inline'>Amsterdam (Saturday)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_91_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.2' type='checkbox'  value='Utrecht (Friday)'  id='choice_4_91_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_91_2' id='label_4_91_2' class='gform-field-label gform-field-label--type-inline'>Utrecht (Friday)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_91_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.3' type='checkbox'  value='Online (Wednesday)'  id='choice_4_91_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_91_3' id='label_4_91_3' class='gform-field-label gform-field-label--type-inline'>Online (Wednesday)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_91_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.4' type='checkbox'  value='Online (Saturday)'  id='choice_4_91_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_91_4' id='label_4_91_4' class='gform-field-label gform-field-label--type-inline'>Online (Saturday)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_91_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.5' type='checkbox'  value='I am willing to follow the training programme in Dutch'  id='choice_4_91_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_91_5' id='label_4_91_5' class='gform-field-label gform-field-label--type-inline'>I am willing to follow the training programme in Dutch<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_85\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you considering enrolling in a specialisation programme after this course?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_4_85'>We are curious to know whether you're already thinking about continuing with a specialisation programme after Coaching and Counselling Year 1. Your response helps us better plan and tailor our support.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_85'>\n\t\t\t<div class='gchoice gchoice_4_85_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Coaching and Counselling English Year 2'  id='choice_4_85_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_4_85\"   \/>\n\t\t\t\t\t<label for='choice_4_85_0' id='label_4_85_0' class='gform-field-label gform-field-label--type-inline'>Coaching and Counselling English Year 2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_85_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Addiction and Recovery Coaching and Counselling'  id='choice_4_85_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_85_1' id='label_4_85_1' class='gform-field-label gform-field-label--type-inline'>Addiction and Recovery Coaching and Counselling<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_85_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='I&#039;m not sure yet'  id='choice_4_85_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_85_2' id='label_4_85_2' class='gform-field-label gform-field-label--type-inline'>I'm not sure yet<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_85_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='I only want to follow Coaching and Counselling Year 1'  id='choice_4_85_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_85_3' id='label_4_85_3' class='gform-field-label gform-field-label--type-inline'>I only want to follow Coaching and Counselling Year 1<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_86\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The programme Addiction and Recovery Coaching and Counselling is a specialisation programme that is only available to those who hold a diploma in coaching\/counselling. Please indicate below which situation applies to you.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_86'>\n\t\t\t<div class='gchoice gchoice_4_86_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='I am attending (or have completed) the training programme Coaching and Counselling Year 1 at the ACC'  id='choice_4_86_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_86_0' id='label_4_86_0' class='gform-field-label gform-field-label--type-inline'>I am attending (or have completed) the training programme Coaching and Counselling Year 1 at the ACC<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_86_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='I have a diploma from the ACC, but I started the training programme before September 2019'  id='choice_4_86_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_86_1' id='label_4_86_1' class='gform-field-label gform-field-label--type-inline'>I have a diploma from the ACC, but I started the training programme before September 2019<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_86_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='I am enrolling with an approved exemption form'  id='choice_4_86_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_86_2' id='label_4_86_2' class='gform-field-label gform-field-label--type-inline'>I am enrolling with an approved exemption form\n<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_86_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='I have not yet obtained a diploma in coaching\/counselling'  id='choice_4_86_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_86_3' id='label_4_86_3' class='gform-field-label gform-field-label--type-inline'>I have not yet obtained a diploma in coaching\/counselling<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_86_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='I have obtained a diploma in coaching\/counselling, but I have not yet received an exemption'  id='choice_4_86_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_86_4' id='label_4_86_4' class='gform-field-label gform-field-label--type-inline'>I have obtained a diploma in coaching\/counselling, but I have not yet received an exemption<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_88\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Addiction and Recovery Coaching and Counselling is a specialisation programme that is only available to those who hold a diploma in coaching\/counselling. If you do not yet hold a diploma in coaching\/counselling, you will need to follow Coaching and Counselling Year 1 before being admitted to this training programme. <a href=\"\/en\/trainings\/coaching-and-counselling\/#register\" target=\"_blank\" rel=\"noopener\">Click here<\/a> to register for our Year 1 programme.<\/div><div id=\"field_4_89\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Diplomas of other coaching\/counselling institutes than the ACC have to be assessed before you can register. If you hold a coaching\/counselling diploma from outside the ACC, please <a href=\"\/en\/contact\/\" target=\"_blank\" rel=\"noopener\">contact us<\/a> to receive the exemption form.<\/div><div id=\"field_4_106\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>Payment preference<\/h2><\/div><fieldset id=\"field_4_39\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Who will pay the tuition fees?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_39'>\n\t\t\t<div class='gchoice gchoice_4_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='I will pay for it myself'  id='choice_4_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_39_0' id='label_4_39_0' class='gform-field-label gform-field-label--type-inline'>I will pay for it myself<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='UWV (Ziektewet, WIA, WW) \/ city council'  id='choice_4_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_39_1' id='label_4_39_1' class='gform-field-label gform-field-label--type-inline'>UWV (Ziektewet, WIA, WW) \/ city council<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_39_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='My employer \/ other party'  id='choice_4_39_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_39_2' id='label_4_39_2' class='gform-field-label gform-field-label--type-inline'>My employer \/ other party<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_92\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you wish to pay for the training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_92'>\n\t\t\t<div class='gchoice gchoice_4_92_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_92' type='radio' value='Pay the full amount at once'  id='choice_4_92_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_4_92\"   \/>\n\t\t\t\t\t<label for='choice_4_92_0' id='label_4_92_0' class='gform-field-label gform-field-label--type-inline'>Pay the full amount at once<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_92_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_92' type='radio' value='Pay the full amount in 3 instalments*'  id='choice_4_92_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_92_1' id='label_4_92_1' class='gform-field-label gform-field-label--type-inline'>Pay the full amount in 3 instalments*<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_4_92'>* Payment in 3 instalments is only possible up to 3 months before the start of the programme.<\/div><\/fieldset><fieldset id=\"field_4_67\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Aanvullende betaalopties voor betaling in \u00e9\u00e9n keer (opleiding Verslaving en Recovery Counsellor)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_67'>\n\t\t\t<div class='gchoice gchoice_4_67_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='Ik wil jaar 1 en jaar 2 in \u00e9\u00e9n keer betalen en ontvang hiervoor \u00e9\u00e9n factuur.'  id='choice_4_67_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_67_0' id='label_4_67_0' class='gform-field-label gform-field-label--type-inline'>Ik wil jaar 1 en jaar 2 in \u00e9\u00e9n keer betalen en ontvang hiervoor \u00e9\u00e9n factuur.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_67_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='Ik wil jaar 1 nu in \u00e9\u00e9n keer betalen en jaar 2 voor aanvang van het tweede jaar in \u00e9\u00e9n keer betalen (je ontvangt de factuur voor jaar 2 drie maanden voor de start van het tweede jaar).'  id='choice_4_67_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_67_1' id='label_4_67_1' class='gform-field-label gform-field-label--type-inline'>Ik wil jaar 1 nu in \u00e9\u00e9n keer betalen en jaar 2 voor aanvang van het tweede jaar in \u00e9\u00e9n keer betalen (je ontvangt de factuur voor jaar 2 drie maanden voor de start van het tweede jaar).<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_93\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >NB: voor de opleiding Verslaving en Recovery Counsellor geldt dat er in 6 maandelijkse termijnen wordt gefactureerd (drie termijnen voor aanvang van jaar 1 en drie termijnen voor aanvang van jaar 2).<\/div><div id=\"field_4_61\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>UWV or city council<\/h2><\/div><div id=\"field_4_52\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><B>Payment by UWV or city council<\/B><BR>\nThis option is only possible if there is already an official application procedure at the UWV or city council for following this training programme.<\/div><fieldset id=\"field_4_54\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you received permission from UWV \/ city council to request a quotation from us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_54'>\n\t\t\t<div class='gchoice gchoice_4_54_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='Yes'  id='choice_4_54_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_54_0' id='label_4_54_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_54_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='No'  id='choice_4_54_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_54_1' id='label_4_54_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Which (social benefit) scheme applies to you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_55'>\n\t\t\t<div class='gchoice gchoice_4_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='WW'  id='choice_4_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_55_0' id='label_4_55_0' class='gform-field-label gform-field-label--type-inline'>WW<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='WIA'  id='choice_4_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_55_1' id='label_4_55_1' class='gform-field-label gform-field-label--type-inline'>WIA<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_55_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Ziektewet'  id='choice_4_55_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_55_2' id='label_4_55_2' class='gform-field-label gform-field-label--type-inline'>Ziektewet<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_55_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='City council'  id='choice_4_55_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_55_3' id='label_4_55_3' class='gform-field-label gform-field-label--type-inline'>City council<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_55_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='gf_other_choice'  id='choice_4_55_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_55_4' id='label_4_55_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_4_55_other' class='gchoice_other_control' name='input_55_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_56\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><B>Please continue to fill in this questionnaire<\/B><BR>\nWe will assess whether you can be admitted to the training programme. You will receive a notification about this via email. The UWV or the city council will request a quotation from us, which we will share directly with them. Once the quotation has been approved, we will finalise your registration for the programme.<\/div><div id=\"field_4_57\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >You can already start with completing the questionnaire below. We can then pre-assess whether you are eligible for joining the training programme. However, please be aware that we can only enroll you once the UWV or the city council has approved your participation. Therefore, please make sure to obtain approval from the UWV or the council as soon as possible.<\/div><div id=\"field_4_94\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>Employer \/ other party<\/h2><\/div><fieldset id=\"field_4_95\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Please indicate below whether the employer \/ other party would like to receive a quotation first, or would like to be invoiced immediately.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_95'>\n\t\t\t<div class='gchoice gchoice_4_95_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_95' type='radio' value='Employer \/ other party wants to receive a quotation first'  id='choice_4_95_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_95_0' id='label_4_95_0' class='gform-field-label gform-field-label--type-inline'>Employer \/ other party wants to receive a quotation first<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_95_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_95' type='radio' value='Employer \/ other party wants to be invoiced straight away'  id='choice_4_95_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_95_1' id='label_4_95_1' class='gform-field-label gform-field-label--type-inline'>Employer \/ other party wants to be invoiced straight away<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_96\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Please fill in the details below to receive a quote.<\/div><div id=\"field_4_97\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><B>Payment employer \/ other party<\/B><BR>\nIf your employer \/ another party pays the invoice, we kindly ask you to fill in the information below.<\/div><div id=\"field_4_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_43'>Company Name<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_4_43' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_44\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_44'>Contact person<\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_4_44' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_45'>Street and house number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_4_45' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_46'>Postal Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_4_46' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_47\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_47'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_4_47' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_48\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_48'>Employer&#039;s reference \/ PO number<\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_4_48' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_49'>Email address for quotation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_4_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_98\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_98'>Email address for invoice<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_98' id='input_4_98' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_99\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What (part of the) amount should be included on the quotation?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_99'>\n\t\t\t<div class='gchoice gchoice_4_99_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_99' type='radio' value='The full amount'  id='choice_4_99_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_99_0' id='label_4_99_0' class='gform-field-label gform-field-label--type-inline'>The full amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_99_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_99' type='radio' value='Part of the amount, being:'  id='choice_4_99_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_99_1' id='label_4_99_1' class='gform-field-label gform-field-label--type-inline'>Part of the amount, being:<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_100\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_100'>Amount to be included in the quotation:<\/label><div class='gfield_description' id='gfield_description_4_100'>Specify the amount that should be included in the quotation.<\/div><div class='ginput_container ginput_container_text'><input name='input_100' id='input_4_100' type='text' value='' class='large'  aria-describedby=\"gfield_description_4_100\"  placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_101\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What (part of the) amount should be included on the invoice?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_101'>\n\t\t\t<div class='gchoice gchoice_4_101_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='The full amount'  id='choice_4_101_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_101_0' id='label_4_101_0' class='gform-field-label gform-field-label--type-inline'>The full amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_101_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='Part of the amount, being:'  id='choice_4_101_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_101_1' id='label_4_101_1' class='gform-field-label gform-field-label--type-inline'>Part of the amount, being:<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_102\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_102'>Amount to be stated on the invoice:<\/label><div class='gfield_description' id='gfield_description_4_102'>Specify the amount that should be included on the invoice.<\/div><div class='ginput_container ginput_container_text'><input name='input_102' id='input_4_102' type='text' value='' class='large'  aria-describedby=\"gfield_description_4_102\"  placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_103\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gf-message-gray gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><B>Please continue with the questionnaire<\/B><BR>\nWe will assess a.s.a.p. whether you can be admitted to the programme. As soon as this is established with a positive result, we will issue the quotation as requested. You will be notified of the result by email. After the quotation has been approved by your employer \/ the other party, we will officially register you for the training programme. <B>Please note:<\/B> in the meantime we will not reserve a place in the training programme, so it is very important that the quotation process can be completed as soon as possible.<\/div><div id=\"field_4_104\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >The remaining part will be invoiced to you. The information below under <B>Personal information<\/B> will be used for billing purposes.<\/div><div id=\"field_4_7\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>Personal information<\/h2><\/div><div id=\"field_4_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_8'>First name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_4_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_9'>Last name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_4_9' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_37\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_37'>Company Name<\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_4_37' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_10'>Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_4_10' type='text' value='' class='large'    placeholder='dd\/mm\/yyyy' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_11'>Place of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_4_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_12'>Street and house number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_4_12' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_13'> Postal Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_4_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_14'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_4_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_28\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_28'>Email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_28' id='input_4_28' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_4_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_16'>Phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_4_16' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_17\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>Motivation & Other information<\/h2><\/div><fieldset id=\"field_4_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I am attending (or have completed) the training programme Coaching and Counselling Year 1 at the ACC.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_71'>\n\t\t\t<div class='gchoice gchoice_4_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes'  id='choice_4_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_71_0' id='label_4_71_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes, but I started the training programme before September 2019'  id='choice_4_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_71_1' id='label_4_71_1' class='gform-field-label gform-field-label--type-inline'>Yes, but I started the training programme before September 2019<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_71_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='No, I am enrolling with an approved exemption form'  id='choice_4_71_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_71_2' id='label_4_71_2' class='gform-field-label gform-field-label--type-inline'>No, I am enrolling with an approved exemption form<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_18\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_18'>1. Please describe your current life situation.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_18' id='input_4_18' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_72\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_72'>1. Please describe your current life situation.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_72' id='input_4_72' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_19\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_19'>2. What education have you followed so far?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_19'>What is your highest level of education?<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_19' id='input_4_19' class='textarea medium'  aria-describedby=\"gfield_description_4_19\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_73\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_73'>2. What education have you followed so far?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_73'>What is your highest level of education?<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_73' id='input_4_73' class='textarea medium'  aria-describedby=\"gfield_description_4_73\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_20\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_20'>3. What training courses have you followed so far, if relevant for this programme? What was the duration of these courses and what was your experience?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_20'>E.g. training in the field of personal development, therapy\/coaching, spiritual development etc.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_20' id='input_4_20' class='textarea medium'  aria-describedby=\"gfield_description_4_20\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_74\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_74'>3. What training courses have you followed so far, if relevant for this programme? What was the duration of these courses and what was your experience?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_74'>E.g. training in the field of personal development, therapy\/coaching, spiritual development etc.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_74' id='input_4_74' class='textarea medium'  aria-describedby=\"gfield_description_4_74\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_21\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_21'>4. What are the important themes in your life so far? Have you recognized any recurring patterns and if so, how have you worked on\/with them?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_21'>To be able to be a good coach\/counsellor it is important to know yourself and your patterns, and to have worked on them.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_4_21' class='textarea medium'  aria-describedby=\"gfield_description_4_21\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_75\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_75'>4. What are the important themes in your life so far? Have you recognized any recurring patterns and if so, how have you worked on\/with them?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_75'>To be able to be a good coach\/counsellor it is important to know yourself and your patterns, and to have worked on them.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_75' id='input_4_75' class='textarea medium'  aria-describedby=\"gfield_description_4_75\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_22\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_22'>5. What is your motivation to enrol in this training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_4_22' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_76\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_76'>5. What is your motivation to enrol in this training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_76' id='input_4_76' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_23\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_23'>6. Are there any matters we should be aware of that might affect your participation in the training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_23'>E.g. mental or physical issues, addictions etc.*<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_23' id='input_4_23' class='textarea medium'  aria-describedby=\"gfield_description_4_23\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_77\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_77'>6. Are there any matters we should be aware of that might affect your participation in the training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_77'>E.g. mental or physical issues, addictions etc.*<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_77' id='input_4_77' class='textarea medium'  aria-describedby=\"gfield_description_4_77\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_29\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_29'>7. If you have suffered from addiction yourself: how long have you been clean for? What have you done to overcome your addiction and what are you currently doing to stay in recovery?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_29' id='input_4_29' class='textarea medium'  aria-describedby=\"gfield_description_4_29\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_4_29'>For participants who have been addicted themselves and want to apply their personal experience in a professional setting, it is important that they are clean before they start with the programme. If this is the case, a conversation with the teacher might take place, to assess whether the applicant has sufficiently recovered to participate in the training programme.<\/div><\/div><div id=\"field_4_41\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><H2>Intake interview<\/H2>\nWorking with addiction-related issues requires certain competencies, motivation, and a particular mindset from you as a coach. To determine whether the programme is a good fit for you, all prospective students take part in a 45-minute intake interview with the teacher. Once you have completed the questionnaire, the teacher will contact you to schedule a (video) call. Based on the information provided in your registration, the interview will explore whether you meet the requirements to participate effectively in the programme, and whether you are personally, developmentally, and intellectually ready to support clients in the future.<\/div><div id=\"field_4_78\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_78'>1. What is your motivation for participating in the Coaching and Counselling Year 2 training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_78' id='input_4_78' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_79\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_79'>2. Are there any practical or emotional issues in your personal situation that might hinder participation in the training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_79'>E.g. available time and space, family issues, illness, pregnancy, etc.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_79' id='input_4_79' class='textarea medium'  aria-describedby=\"gfield_description_4_79\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_4_81\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >3. Have you encountered themes in the Coaching and Counselling Year 1 training programme that you are still working on\/processing (unfinished business)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_81'>\n\t\t\t<div class='gchoice gchoice_4_81_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='Yes'  id='choice_4_81_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_81_0' id='label_4_81_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_81_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='No'  id='choice_4_81_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_81_1' id='label_4_81_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_80\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_80'>4. What are these themes and how are you working on processing them (by yourself or with support)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_80' id='input_4_80' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_82\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_82'>5. How do you expect to deal with (processing) these themes throughout the next training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_82' id='input_4_82' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_83\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_83'>6. Could this process complicate participation in the training programme?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_83' id='input_4_83' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><b>* Note:<\/b> You are not obliged to share any medical details with us. By submitting this form you state that you have no severe psychological problems, and\/or are not receiving psychiatric treatment at this time, as we consider this to be grounds for exclusion from admission. The training programme is not meant as therapy, but to help you become a coach\/counsellor. For this reason, we apply a strict assessment for admission to our training courses, as certain psychological problems may impede your own learning process (as well as that of your fellow students). If in doubt, we will always contact you first to discuss this further.<\/div><div id=\"field_4_31\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>Last but not least<\/h2><\/div><fieldset id=\"field_4_33\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you know the ACC?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_33'>\n\t\t\t<div class='gchoice gchoice_4_33_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Google'  id='choice_4_33_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_33_0' id='label_4_33_0' class='gform-field-label gform-field-label--type-inline'>Google<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_33_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Facebook'  id='choice_4_33_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_33_1' id='label_4_33_1' class='gform-field-label gform-field-label--type-inline'>Facebook<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_33_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='LinkedIn'  id='choice_4_33_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_33_2' id='label_4_33_2' class='gform-field-label gform-field-label--type-inline'>LinkedIn<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_33_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Friends \/ family'  id='choice_4_33_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_33_3' id='label_4_33_3' class='gform-field-label gform-field-label--type-inline'>Friends \/ family<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_33_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='I have previously followed a training programme with the ACC'  id='choice_4_33_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_33_4' id='label_4_33_4' class='gform-field-label gform-field-label--type-inline'>I have previously followed a training programme with the ACC<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_33_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Dag van Herstel'  id='choice_4_33_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_33_5' id='label_4_33_5' class='gform-field-label gform-field-label--type-inline'>Dag van Herstel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_33_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='gf_other_choice'  id='choice_4_33_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_33_6' id='label_4_33_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_4_33_other' class='gchoice_other_control' name='input_33_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_70\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you attended an open day or online information session of the Academy for Coaching and Counselling?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_70'>\n\t\t\t<div class='gchoice gchoice_4_70_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='Yes'  id='choice_4_70_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_70_0' id='label_4_70_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_70_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='No'  id='choice_4_70_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_70_1' id='label_4_70_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_107\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Declaration of Accuracy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_107'><div class='gchoice gchoice_4_107_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.1' type='checkbox'  value='I have filled in the information on this form correctly and to the best of my knowledge. I am aware that withholding or incorrectly sharing information may have consequences for my participation in the training programme.&lt;font color=&quot;red&quot;&gt;*&lt;\/font&gt;'  id='choice_4_107_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_107_1' id='label_4_107_1' class='gform-field-label gform-field-label--type-inline'>I have filled in the information on this form correctly and to the best of my knowledge. I am aware that withholding or incorrectly sharing information may have consequences for my participation in the training programme.<font color=\"red\">*<\/font><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_108\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Privacy Statement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_108'><div class='gchoice gchoice_4_108_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.1' type='checkbox'  value='I consent to the processing of my data according to the &lt;a href=&quot;https:\/\/www.counselling.nl\/en\/privacy-statement\/&quot; target=&quot;_blank&quot;&gt;privacy statement&lt;\/a&gt;.&lt;font color=&quot;red&quot;&gt;*&lt;\/font&gt;'  id='choice_4_108_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_108_1' id='label_4_108_1' class='gform-field-label gform-field-label--type-inline'>I consent to the processing of my data according to the <a href=\"https:\/\/www.counselling.nl\/en\/privacy-statement\/\" target=\"_blank\">privacy statement<\/a>.<font color=\"red\">*<\/font><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_110\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >General Terms and Conditions<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_110'><div class='gchoice gchoice_4_110_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.1' type='checkbox'  value='I understand that by submitting this questionnaire, as soon as the quotation has been approved, I will enter into a binding agreement with the Academy for Coaching and Counselling, which entails a payment obligation, and I have taken note of the applicable &lt;a href=&quot;https:\/\/www.counselling.nl\/en\/general-terms-and-conditions\/&quot; target=&quot;_blank&quot;&gt;general terms and conditions&lt;\/a&gt;.&lt;font color=&quot;red&quot;&gt;*&lt;\/font&gt;'  id='choice_4_110_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_110_1' id='label_4_110_1' class='gform-field-label gform-field-label--type-inline'>I understand that by submitting this questionnaire, as soon as the quotation has been approved, I will enter into a binding agreement with the Academy for Coaching and Counselling, which entails a payment obligation, and I have taken note of the applicable <a href=\"https:\/\/www.counselling.nl\/en\/general-terms-and-conditions\/\" target=\"_blank\">general terms and conditions<\/a>.<font color=\"red\">*<\/font><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_109\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >General Terms and Conditions<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div 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href=\"https:\/\/www.counselling.nl\/en\/general-terms-and-conditions\/\" target=\"_blank\">general terms and conditions<\/a>.<font color=\"red\">*<\/font><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_4' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Send'  \/> <input type='hidden' name='gform_ajax' value='form_id=4&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=1f75338aebada0929b33ad3f309296fa' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_4' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_4' id='gform_theme_4' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' 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