Application for Certification Training Program

ISST International Certification Program in Schema Therapy

Belgrade Schema Therapy Centre

Name

Address

Email

Telephone number

Profession

Current position/ Organization

Education (please list all your degrees with dates you qualified)

Degree and date qualified

Previous psychotherapy training (please give details of the approach, the name of the trainer or
the centre, years and content of training, previous and current supervisor(s), supervision hours
and other relevant information)
Work experience (please give details of past and present psychotherapeutic experience with
clients, including clients with personality disorders)

Previous experience with schema therapy

Please describe your motivation and reasons for training in schema therapy

Fluency in English (please describe your ability to attend lectures, read and write in English)

Date _________________ Signature _________________