аЯрЁБс>ўџ 79ўџџџ6џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС @ №Пjbjbj{Ю{Ю ..ЄЄjџџџџџџˆjjjjjjj~,~ГъVllllGV$С2444444$RяЈXj$GG$$Xjjllлm–––$djljl2–$2––jj–lJ аNFџЮ2Ъˆ”–ƒ0Г–—.—–~~jjjj—j–ˆеvKT–ŸDуAеееXX~~„JL~~The Scottish Institute of Human Relations - understanding people - Application Form for Membership Applications should enclose a curriculum vitae and the names of two existing members willing to act as sponsors. If you do not know anyone within SIHR please let us know how you heard of SIHR and someone from the membership committee will arrange to meet with you. Sponsor 1: Name: Phone and/or Email: Sponsor 2: Name: Phone and/or Email: The request for ‘sponsors’ and the detail in the form is NOT intended as a filter or means of excluding applicants. Sponsors can only help individuals to join; they cannot exclude individuals. The detail is sought so that SIHR can get to know the multiple talents and interests of individuals who belong, and thus engage with them more fully. Items in the forms which applicants feel are irrelevant to their particular experience, or which they want to keep private, can be left blank. 1. Name: 2. Home Address: 3. Home Telephone Number: 4. Email: (if given it will be used for contact and information) 5. Current Work address: 6. Work Telephone Number: 7. Title of Present Post: 8. With which professional bodies are you registered? SIHR membership application form, page 2 9. Please give details of any courses, or trainings which you have undertaken at SIHR: 10. Please give details of any other psychoanalytic / psychodynamic /systemic courses, or trainings which you have undertaken at other Institutions: 11. Please outline your present / past involvement (if any) with SIHR. eg. membership of groups, committees, seminars etc: 12. Please give a brief description of how you are involved in psychoanalytic / psychodynamic /systems theory and practice outwith the SIHR: 13. Are you currently a student on a SIHR course? If so, which? 14. Can you provide us with the name of a reference him/herself with a psychoanalytical /psychodynamic/systemic background? (This can be one of your sponsors, but it may be particularly helpful those new to Scotland and SIHR to share other links.) 15. What are your particular areas of interest? (please include 'outside' interests e.g. art, music here) 16. Could you please list any relevant publications; books, papers or articles: 17. Members often have areas of interest which they would like to develop further. How might we help you? What would you like to gain from your membership? 18. Members also come into the SIHR with various areas/levels of expertise which they feel they might use to contribute to the work of SIHR. Vacancies sometimes arise for members to work in the teaching and clinical programmes. Application can then be SIHR membership application form, page 3 made for joining colleagues in this work. Please include, for our record, any useful experience you may have, not only in terms of our internal clinical, and training functions but also other skills /interests you would consider using to SIHR’s benefit, eg. accounting, fund raising, marketing, computing, library work, conference and function administration, law, research, audit, ethics, liaison with other institutions etc: 19. Do you have links with other organisations which might be usefully used for mutual benefit. e.g. in advertising our work, providing services, or coordinating joint work? 20a. Have you undertaken personal therapy, counselling or group work? b. If ‘yes’ please give indication of type, length and frequency. (Some query the need for this question, anyone can omit it; it is information that tells us something of the breadth of an applicant’s experience, and helps to provide a membership profile.) 21. Any further comments or requests: This information will be put into a database for organisational use by staff and members; can we remind you to update it from time to time! Thank you. Declaration; I have read the SIHR Criteria for Membership, and Articles of Association, and agree with its aims and agree to abide by its Code of Ethics. I agree to this information being available within the organisation on a database and at some later date on a protected website (access by password only). Signed................................................................Date.................................................... Please return to Membership Committee Secretary, SIHR, 172 Leith Walk, Edinburgh EH6 5EA or e-mail to infor@sihr.org.uk The Scottish Institute of Human Relations Ltd is registered in Scotland as a company limited by guarantee. No 56781. Registered charity no SC013051 Registered office: 172 Leith Walk, Edinburgh EH6 5EA.  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