Monthly Group Mentor Coaching - Single Session Registration

Name *

First

Last

Email *

This is the email that all program correspondence and invoices will be sent to.

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Where and when did you receive your coach training? (If currently in training, list your program) *

Approximately how many hours of coaching have you logged? *

Your current ICF credential level: *

None: currently in training, recently completed training, or in the process of applying
ACC
PCC
None: not pursuing credential

Your reason for joining the Group Mentor Coaching experience is: *

When does your credential expire?

I'd like to register for the following Group session(s) ($175 each): *

Preparatory information and the Zoom link will be provided approximately one week before the scheduled session.

Please contact me, I'd like to schedule one or more 1:1 mentoring sessions:

A scheduling link will be sent upon registration.

Did someone refer you to this program? If so, please let me know who so I can thank them!

Additional Comments or Questions

Please confirm you agree to the following; all are required. *

I commit to attending all group and/or individual scheduled sessions.
I will actively participate, support my coaching colleagues, take responsibility for my learning, communicate openly and honestly, and honor confidentiality and the group agreements established in the session.
I understand my registration is not complete until I have paid my invoice (One monthly session = $175. Invoice sent via Square to the email you provided above)
My program investment is non-refundable (exception: program cancellation).
I agree to receive emails related to the program, including reminders and session materials. My email will not be used for any other purpose.
If I’m applying for or renewing a credential, I understand that up to 7 hours of group mentoring can be applied to the 10 hours required by ICF
If I’m applying for a credential, I understand that participation does not guarantee that I will be awarded the credential I am seeking from the ICF.

Signature (initials are fine) *

Monthly Group Mentor Coaching – Single Session Registration