Certificate in Coaching

Certificate in Coaching

Application Form

Thank you for your interest in the Certificate in Coaching provided by Prescott College. The form below is a fill-in Word document with enough space for your answers. Please answer all questions below in the space provided.

Submit application to instructor: Laurel Inman -

You will be contacted for an interview following receipt of your application. Thank you!

Your Name:
Mailing Address:
City, State, Zip:
Phone:
Email:
Date of Birth:
Today’s Date
What is your current or past affiliation with Prescott College (i.e. student, alumni, faculty, staff, parent, no affiliation)?
How did you hear about this Certificate program?
What brings you to this Certificate program and what are your goals for having this Certification?
What areas of Coaching interest you the most (i.e. leadership, wellness, life coaching, etc.)?
The pre-requisites of this Certificate program include:
·  Two hours of coaching, by a certified coach, completed pre-entrance. / ¨ Yes, I will meet the pre-entrance requirements.
Will you pay tuition in one installment, or request a payment plan?
There are six courses in the Certificate program. Can you commit to participating in all six courses in the order scheduled? / ¨ Yes, I will take all six courses for the dates scheduled and for which I am registered.
Please describe what self-development work you have accomplished in your life:
The information I provided is accurate and complete. I consent to a review of my application and a subsequent interview. I understand that completion of this application does not guarantee my participation in the Certificate program, and that if I am invited to register, I will register within the necessary timelines, using the official forms provided by Prescott College. / Signature:
Date: