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Home > Become a Blanchard Coach > Coach Application
Coach Application
General Information
First Name*
  MI
  Last Name*
Address
(line 1)
(line 2)
City
Country
State/Province
Zip/Postal Code
Phone*
( )
    ext.   Fax
( )
 
E-Mail*
How did you hear about Coaching.com?
Approximately how many hours per week would you be willing to dedicate to Coaching.com clients?
 

Undergraduate Degree (University)
  Major
Graduate Degree (University)
  Major
Have you completed ICF Accredited Coach Training
Yes   No
  If yes, from where?
  Completion Date (MM/DD/YY)
360 Certification


Other Formal Training
Completion Date (MM/DD/YY)
Are you ICF certified?
Yes   No
  Certification Level
  Completion Date (MM/DD/YY)
Affiliations
  Previous Profession or Occupation

Work Experience - Please provide us with the past 10 years of your work experience.

Company Address Company Phone Position Dates of Employment
 

Coaching Experience

Do you have a coach?
Yes   No
  How long?
How did you get started in coaching?
How many years have you earned money as a coach?
What percentage of your business is coaching?
Please select all industries you have worked in. (Use Ctrl key for PC or Command key for Mac to select multiple industries or to deselect.)
     Other:

Please describe your typical client? (Choose top 3)

Average number of months you work with clients

Average number of hours you meet with client per month

  Comments about your clients:
What percentage of your time coaching a client is done over the phone?
What languages can you coach in? Ctrl-click (PC) or Command-click (Mac) to select multiple items
Please list all software applications that you are familiar with.
 

Additional Information

Given what you know so far, what makes you interested in Coaching.com?
What experience do you have coaching leaders?
How familiar are you with the Situational Leadership® II Model?
If you are familiar with it, what experience do you have applying it?
Describe any experience you have with sales or coaching salespeople.
What are some of your favorite models/concepts/frameworks/principles that you use consistently in your work?
If you could change one thing about the world in this lifetime, what would it be?
In your lifetime, who are your heroes?
What is your favorite book?
  What is your favorite movie?
Please describe your most interesting experience of the past 3 months?
 

References - Please list three references. (Include 1 coaching client.)
Name
  Company
Address
  Relationship to you
City
  State
  Zip
Phone
()
    ext.

Name
  Company
Address
  Relationship to you
City
  State
  Zip
Phone
()
    ext.

Name
  Company
Address
  Relationship to you
City
  State
  Zip
Phone
()
    ext.