CERTIFICATION APPLICATION FORM

The Coaches Training Institute

This document is a legally binding agreement.

You should read the Certification Program Information Packet thoroughly prior to completing this application to ensure you are familiar with all aspects of the program before you sign this agreement.

Section A: Contact Information

Section B: Coaching Information

Your Coach‘s Current Certification

*You are required to coach a minimum on one hour per month, with your certified coach, during the 6 month certification program.

The scheduling process for the actual classes (pods) will take place during the first half of the month, previous to the month, in which you are registered. The scheduling process is done via email and you will need email access during this time. See the Certification Info Packet for more info on the scheduling process.

Section C: Materials Delivery

The certification course materials are delivered in electronic format. Hard copy materials are available for an additional fee. You will be given access and instructions to order hard copies, should you choose to, after you have been confirmed into an actual Pod and have been given access to the CPCC website. Prior to your program start date you will receive access to an online community where you can download the program materials at no additional fee.

Section D: Payment Information (All prices are in U.S. Dollars)

Registration: The Certification Program is a 25 week telecourse with 92 hours of coach training. Please check the appropriate box below to indicate your registration status:

Regardless of how you registered, your remaining balance is to be paid in five automatic credit card charges each, beginning the 1st of the month following the start date of your program and approximately every 30 days thereafter. These payments will be charged to the credit card you provide. If, for any reason your account is behind, CTI may charge your card to bring your account current.

Section E: Agreements

Thank you for enrolling in the Certification Program. You are about to begin an exciting journey toward your coaching mastery. Please note: this agreement is a legally binding instrument upon written acceptance of your participation in the program you are enrolling in unless cancelled pursuant to the Buyer’s Right to Cancel.

My agreement below indicates:

• I have read and understand all aspects of the Certification Program as described in the Certification Program Information Packet, including the confidentiality agreement and CTI‘s cancel, refund and transfer policies

• I approve the charges CTI will make to my credit card as outlined in Section D above.

• I agree to pay $140 for each missed supervision.

• I understand that pod and triad calls may be recorded for training purposes or for the use of other pod members.

• I understand that the recordings of my oral exam may be used for CTI examiner training purposes.

• I agree to take the actions as required by the program design.

• I intend to be a full-out team player in this program and can be counted on to encourage, coach, and support my fellow program participants to do the same.

• Throughout the program, I can be counted on to be honest and coachable.

Please be patient and Click "Submit" once! It takes a bit for the data to be recorded. Once it is finished, you will be returned to the main landing page. You will need to go back to the registration page to complete the application process by submitting your credit card information.