ICLP PATHWAYS · VERSION 1.0

Counsellor & Organisation Onboarding Application

Complete and submit this form to begin the ICLP Pathways vetting process

This application starts the verification process required before any Individual, Cohort, School or Programme account is activated on ICLP Pathways. Please complete every field accurately — incomplete applications will delay your onboarding.

Download the fillable PDF

Before you start

Important: the typed name below is not a legally binding electronic signature. It records what was typed, not a verified identity. This document must be printed and formally signed by hand before it takes effect, and the signed copy filed by the ICLP Platform Admin.

1. Account Type

Choose the one that describes the account you are applying to open.

IndividualCohortSchoolProgramme

2. Applicant Details

Full legal name *Preferred name / titleOrganisation name (if applicable)Role at organisationEmail address *Phone numberCountry / jurisdiction *Government ID / passport no.Used only to match your application to the identity document you provide during vetting.

3. Qualifications & Credentials

Relevant qualification(s) *Issuing institutionProfessional body / registration no.Years of relevant experienceEstimated number of students/staff you intend to guide

4. Professional References

ICLP contacts at least one reference directly. Please give people who can speak to your professional conduct.

Reference 1 — name *Reference 1 — email / phone *Reference 2 — nameReference 2 — email / phone

5. Consent & Declarations

I consent to ICLP Pathways verifying my identity, qualifications and, where legally available, conducting a background/police clearance check.
I have read and agree to be bound by the ICLP Pathways Counsellor Code of Conduct.
I consent to ICLP Pathways processing my personal data for the purposes of vetting, account administration and platform safety.
I declare that the information provided in this application is accurate and complete to the best of my knowledge.

6. Signature

Typed full name (signature) *Date *

FOR ICLP PLATFORM ADMIN USE ONLY

Completed by the ICLP Platform Admin only. An applicant cannot see or edit this box. Nothing moves from Pending to Verified until identity, credentials, background clearance, at least one directly contacted reference and a signed Code of Conduct are all on file.

Vetting statusChecked byDateSigned paper copy on file

Still to complete: Full legal name, Email address, Country / jurisdiction, Relevant qualification(s), Reference 1 — name, Reference 1 — email / phone…

8 required fields on this form. Your answers go to the ICLP team at iclppathways@gmail.com and are used for vetting, account administration and platform safety.

ICLP Pathways · Onboarding Application · A company governed under ICanLearnProgram International · iclppathways@gmail.com · [Add the ICLP contact phone number before publishing] · [Add the ICLP postal address before publishing]