APPLICATION FORM FOR FELLOWSHIP OF THE
BABCP
Thank you for your application for Fellowship of the BABCP.
The Fee payable on application is £150.00. Please make your cheque payable to BABCP. In the event
of your application not being successful BABCP will refund your fee less £50.00 Administration costs.
Your application will be critically reviewed and rated by the Fellowship Committee, a sub-group of the
BABCP Board. It’s considered recommendation and the Board of Trustees’ decision is final. There is no
appeals process.
The award of “Fellow of the BABCP” is reserved for those who have demonstrated sustained
commitment to the values and objectives of the BABCP. It entitles you to use the title “Fellow of the
BABCP”.
The primary aim of the Fellowship is to recognize those members who have made a significant
contribution to the development of CBT and BABCP. We do not expect more than 5% of our members
to fulfil the required criteria. A substantial contribution to CBT may be in areas of: (a) clinical service;
and/or (b) research; and/or (c) teaching/training; and/or (d) service development; and/or (e) services to
the BABCP.
No documentation will be considered other than the application form and the citation of the Proposer
and Seconder unless otherwise requested by the Fellowship Committee.
Applicants will be current subscribing members of the BABCP and will have held that membership for a
minimum period of 5 years.
Applicants will have been engaged in the CBT field in the United Kingdom for a minimum of 10
years.
Applicants will be proposed and seconded by current subscribing members of the BABCP. The
Proposer and Seconder will provide a joint citation of not more than 300 words in support of the
nomination.
The Proposer and Seconder should not be members of the Fellowship Committee or have any potential
conflicts of interest. If a member of the Fellowship Committee is nominated for Fellowship then the
member will not be involved in the evaluation of his or her nomination.
Successful applicants will be notified by post and announced in CBT Today and on the BABCP website.
They will be entitled to call themselves a Fellow once their status has been confirmed.
Unsuccessful applicants will be notified by post.
NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
Notes for completion of this form:
To enter information please set your cursor in the boxes. Moving through fields should be done with
the tab key; using the return key will expand the current field.
APPLICANT’S DETAILS
We nominate for election to the Fellowship of the BABCP:
Name:
Give below a summary assessment of his/her professional career and reasons for recommendation (in
no more than 300 words) (Free text)
DECLARATION
I confirm that I have read this application and to the best of my knowledge and belief the
information the applicant has given is correct. I am prepared to support the case made by the
candidate for election to Fellowship as recorded above in the citation that I have prepared.
PROPOSER
Full Name
BABCP membership number
Signed
Date
SECONDER
Full Name
BABCP membership number
Signed
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NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
Date
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NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
APPLICANT’S DETAILS
Full Name
BABCP membership number
Title
Mr
Mrs
Ms
Miss
Dr
Prof
Other (state)
Address
Post Code
Email
Tel Home / Mobile
Profession
Date of Birth
Undergraduate Education
Dates
Institution & Qualification
Job Title
Postgraduate Education / Qualifications
Dates
Institution & Qualification
Job Title
Principal Appointments since core professional training (inc. Honorary Appointments)
Dates
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Employed by (or Private Practice)
Job Title
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NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
Current Appointment(s) or Position(s)
Dates
Employed by (or Private Practice)
Job Title
Your nomination will go to the Fellowship Committee, a sub-committee of the Board. Your peers
will make a judgment based on quality and quantity, and due consideration will be given to all
areas. The listing given below is alphabetical and does not suggest a hierarchy for rating
purposes. It may feel unnatural, but you should declare what you have achieved. E.g. it is
important to say you were a Course Director of your local teaching course in CBT, but what did
you do that was over and above what was expected in your role? The committee recognize that
some contributions are easier to describe in terms of concrete and specific achievements
Clinical Service to Clients
(Maximum 400 words) (Free text)
What have you done over and above what may be expected for clients to improve your quality of care? Have you developed
specific expertise? Have you provided an exceptional service in the absence of support ? Please highlight your top two
achievements, including year, in this section.
Research
(Maximum 400 words excluding references) (Free text)
How have you made a significant contribution to the knowledge base through research? Provide a description of your research
in the development or practice of CBT. Provide a maximum of 15 references of your papers with the highest impact. List any
major grants or awards. Please highlight your top two achievements, including year, in this section.
Examples: “I developed a model for peer supervision over a webcam and compared it to using the ether by randomisation to 4
different centres. We were able to demonstrate that webcam is an effective method of supervision.”
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NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
Research References
Please use the space given below to give details of your top ten references (or copy and paste in priority order from
your C.V.).
Teaching/Training
(Maximum 400 words excluding references) (Free text)
Provide a description of your significant contribution to teaching, which may include introducing innovative ideas. Applicants
should describe the significance/impact of the training. Provide a maximum of 15 references of teaching articles, books
you have written or courses and workshops you have provided. List any awards or honours achieved.
Examples:
“I developed an innovative teaching workshop for BABCP conferences for applying statistics for single case experimental
designs. At the end of the workshop, students are able to use a randomization test for multiple baseline designs. It has been
rated as highly satisfactory”
Teaching/Training References
Please use the space given below to give details of your references (or copy and paste in priority order from your
C.V.)
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NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
Service Development, Administration or Management
(Maximum 400 words) (Free text)
Give details of any ways that you have developed a service for clients; provided leadership or a management role in
your organisation or contributed to policy making. List any awards or honours achieved. Please highlight your top
two achievements, including year, in this section.
Examples:
“I developed a specialist service for trapped finger pain. At our last audit, our clients rated our service as very satisfactory.”
“I have managed our local CBT department for the past 3 years. During this time I managed to persuade my line manager to
increase our budget for an extra 2 therapists. Throughout this period I was able to pay for 80% of my staff to attend the BABCP
conference.”
“I was on the NICE committee that developed guidelines for bloated head syndrome. Without my contribution, it is unlikely to
have developed the guidelines for this syndrome.”
Services to the BABCP
(Maximum 400 words) (Free text)
Give details of any voluntary role that you have done for the charity and what you achieved during that time. Please highlight
your top two achievements, including year, in this section. List any awards or honours.
Example: “I was the Chair of the Outer Hebrides Branch of the BABCP from 2001-2003 and during that time, I led a team that
increased the number of workshops from 1 to 3 per year, and increased the average attendance from 10 to 50.“ “I was Editor of
the BABCP Journal from 2001-2007 and during that time, our impact factor rose from 1 to 2.”
Please provide any other information relevant to your professional career for nomination.
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NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
(Maximum 400 words) (Free text)
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NOMINATION FORM FOR FELLOWSHIP OF THE BABCP
Criminal, Civil, Investigatory & Disciplinary Declarations
All applicants must answer each of the six questions below
If you answer YES to any question, please declare details on an attached statement
Question
Declaration
1. Have you ever been convicted of any criminal offence in any
court in the UK or elsewhere which might prejudice the public’s
trust in you, your profession, or the BABCP, if accurately
informed about all the circumstances of the case?
Additional
Statement
Enclosed
Labelled
as
YES
NO
YES
2. Have you ever been found guilty of a civil offence?
NO
3. Have you ever been refused / expelled from membership of any
other professional body / register on the grounds of professional
misconduct or other professionally related offence?
YES
4. Have you ever been the subject of any professionally related
disciplinary action (which may or may not have ended in
dismissal)?
YES
5. Are you currently / likely to be the subject of any criminal, civil,
investigatory or disciplinary proceedings or enquiries?
6. To your knowledge, have you ever been, or are you likely to be
involved in a situation or incident likely to result in disciplinary
action against you as a member of the BABCP?
NO
NO
YES
NO
YES
NO
DELIBERATELY FALSE STATEMENTS WILL RESULT IN YOUR REMOVAL FROM THE LIST OF MEMBERS
DECLARATION
I agree to be nominated as a Fellow of the BABCP, will abide by the rules of the nomination
process, and understand that the decision of the Fellowship Committee and Board is final.
Signature
Date
Completed forms should be sent with your remittance of £150.00 to
Freepost RSHG-HYHY-LSHJ
BABCP
Imperial House
Hornby Street
BURY
BL9 5BN
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