All nomination submissions must use this nomination form. More information on the PRISM 2016 Award Event and nomination process can be found online at

NOMINATION DEADLINE:

Email your completed form to

5 p.m. Pacific, Friday, August 19, 2016.

Nominations Form Instructions

Parts 1 and 2 to be completed by the Coach Nominee

Part 3 to be completed by the Client

Table of Contents

Part 1 – Nominations Form: Demographics

Award Category

Coach Nominee Information

Client Information

Part 2 – Detailed Evaluative Criteria

Snapshot of the Coaching Initiative

Details and Examples Coaching Initiative

STANDARDS

STRATEGY

SUSTAINABILITY

IMPACT

Part 3 – Client Impact Statement & Release

Client Impact Statement

Client Release

Part 1 – Nominations Form: Demographics

Award Category

Please check the award category that you are submitting this nomination for.

Top of Form

☐ / Life Coaching / ☐ / Business Coaching

Bottom of Form

Coach Nominee Information

Please provide contact details for thecoach being nominated (must be an ICF Credentialed Coach with an up-to-date membership and be in good standing):

Name: / Click or tap here to enter text. /
Business Name: / Click or tap here to enter text.
Phone: / Click or tap here to enter text.
ICF Membership Number: / Click or tap here to enter text.
ICF Credential: / ☐ ACC ☐ PCC ☐ MCC
Email: / Click or tap here to enter text.

Client Information

Please provide information about the client.

Date Coaching Initiative was implemented: / Click or tap to enter a date.
Client Name: / Click or tap here to enter text.
Location of Client (Must be in British Columbia): / Click or tap here to enter text.
Current Status of Coaching Initiative (completed, ongoing, expanding and ongoing, etc. Coaching Initiative must have been active within the last 24 months): / Click or tap here to enter text.

During the nomination review process, the panel of judges may contact the Coach Nominee or the Client to provide additional, clarifying information about the coaching initiative including participant testimonials if required.

Part 2 – Detailed Evaluative Criteria

  • Coach of the Year Judges will not be informed of the name of the Coach Nominee or Client Name when judging the nomination including the evaluative criteria.
  • For the remaining sections of this Nomination Form we ask that you refrain from identifying the proper name of Coach Nominee, Client or anyone associated with the coaching initiative. Rather, please provide anonymous references (e.g. the coach, the client, etc.).
  • The nomination form will be returned to you for editing if identifying names are referenced in the following sections.
  • If you choose to answer the questions below on a separate document, please ensure the Coach Name is clearly stated on the top of every page, including page numbers in the format “Page * of * ”.

Snapshot of the Coaching Initiative

  1. As the Coach Nominee, please describe why you feel that you, through this coaching initiative, should be recognized for an ICF Vancouver Coach of the Year Award (250 words or less):
  1. Please describe the general scope of the coaching initiative (250 words or less):

Details and Examples Coaching Initiative

These Awards require applicants to demonstrate how their coaching initiative meets four key areas:

  1. Standards
  2. Strategy
  3. Sustainability
  4. Impact

STANDARDS

Provide examples of how the coaching initiative was developed in a way that would highlight a commitment to rigorous professional standards, industry excellence or best practices within organizational coaching. Examples could include, but not be limited to, the following (500 words or less):

  • Coaching initiative utilizes coaches who hold an ICF Credential
  • Professional contracts were used
  • Coaches involved in the initiative have been offered coach mentoring/coaching supervision
  • ICF Code of Ethics has been discussed with client and adhered to; in particular, confidentiality has been preserved in coaching conversations
  • Clear rationale for using coaching as the preferred solution.

Click or tap here to enter text.

STRATEGY

Provide specific examples of how goals, priorities or needs have/are being addressed through the coaching initiative. Examples could include, but not be limited to, the following (500 words or less):

  • Coaching initiative aligns with goals, values, or behaviors
  • Coaching initiative has proven to be adaptable and has evolved to serve client needs
  • Coaching has become a fundamental element to the client’s success.

Click or tap here to enter text.

SUSTAINABILITY

Provide examples of how coaching has become embedded into the client’s lifestyle or identify any plans to develop/expand the coaching initiative further. Examples could include, but not be limited to, the following (500 words or less):

  • Coaching has become positioned as a preferred solution when compared to other modalities
  • Coaching shows long-term resilience in ongoing success of the client
  • The client’s outlook, attitudes, behaviours, or skills have changed positively resulting from the coaching.

Click or tap here to enter text.

IMPACT

Provide any observable and measureable details that underscore the value, influence or effectiveness of the coaching initiative. Examples could include, but not be limited to, the following (500 words or less):

  • Any metrics, statistics, or data from evaluations or measurement tools used
  • The client provides positive testimonials that demonstrate the breadth and/or depth of coaching initiative
  • Client indicators provided that validate increased levels of engagement and well-being (e.g. decreased stress, increased resilience, goal attainment)
  • Return on Expectations (ROE) measurements provided for non-monetary client goals that were identified before coaching initiative was implemented.

Click or tap here to enter text.

Part 3 – Client Impact Statement & Release

(To be completed by the Client)

Client Impact Statement

As the Client, please describe the impact that the coaching had on you. Please include goals on the onset, the use of contracts, references to confidentiality, tools and methods used to support you, impact on you personally, impact on those around you, what worked well for you in the coaching, etc. (500 words or less):

Click or tap here to enter text.

Client Declaration of Impact Statement

I verify that the above statement is accurate and was written solely by me and in my own words.

Client Signature: ______Date:Click or tap to enter a date.

Client Release

I hereby authorize the Vancouver ICF Chapter permission in perpetuity, to share my name and my coaching story with the community through media, social media, marketing, other modes of communication, and at the Awards Event.

☐ Agree to share my name and my coaching story

☐ Agree to share my coaching story but have my name remain anonymous

Client Signature: ______Date:Click or tap to enter a date.

NOMINATION DEADLINE:

Email your completed form to

5 p.m. Pacific, Friday, August 19, 2016.

For questions please contact the PRISM Committee at

PRISM 2016: The Future is CoachingPage 1 of 7