JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Institute for Equity-Centered Coaching: Application for Certification
Thank you for your interest in becoming a Certified Coach and/or Leader with The Institute for Equity-Centered Coaching. Our 2024- 2025 cohorts are forming now.
Please fill out the application completely. After your application is reviewed you will hear from us via email about your application status within 24-48 hours during business days. Your application status email will contain the next steps about finalizing your enrollment if you are accepted.
Submitting this application does not obligate you to join. You will have the option to get on the phone with our enrollment coordinator if you have further questions if your application is accepted.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
Phone number (US Only & Canada)
*
Your answer
Relevant Social Media Handles you are active on
Your answer
Race/Ethnicity (please share how you identify)
*
Your answer
Gender Identity & Pronouns
Your answer
Age Range
24 or younger
25-30
30-39
40-49
50-59
60+
Clear selection
Please share a little bit about your current work/role/or business.
*
Your answer
Please share some information about your previous experience with antiracism, and/or diversity, equity, and inclusion work. (Programs you've taken, books you've read, how long you've been engaged in this learning journey)
*
Your answer
What track are you applying for:
*
Coach Track
Leader Track
Both
Unsure- I need more information
How soon are you ready to start (approximately)?
*
Summer 2024 - Cohort 6
Not sure
Required
Please tell us a bit about your previous experience with coaching or leadership training including if you hold any current certifications, degrees, or specialized training.
*
Your answer
Tell us why you're interested in becoming Certified by the Institute for Equity-Centered Coaching and how you plan to use this training in your work.
*
Your answer
Let us know if you've taken other programs with Trudi or the Team at The Institute for Equity-Centered Coaching.
*
Your answer
What's your biggest concern when it comes to practicing Antiracism and DEI principles in your business, role, and/or coaching program?
*
Your answer
Please share your thoughts about the role and responsibilities of White people in antiracism and DEI practice.
*
Your answer
Please share something about your experience working and learning in multiracial communities.
*
Your answer
How do you hope this certification(s) will enhance your coaching or leadership practice?
*
Your answer
What gaps do you believe exist in your current coaching or leadership skills?
*
Your answer
We have a limited number of partial scholarships for people who hold underrepresented identities. Scholarship amounts are $2,000. If you hold an underrepresented identity and would like to be considered for a partial scholarship because you have financial barriers to participating at the full cost please let us know. (Check all that apply)
Yes - I am a member of a marginalized community and have financial need. Please consider me for a partial scholarship.
If I am not awarded financial support, I will not be able to participate.
If I am not awarded financial support I will be able to participate but may need an extended payment plan.
How did you learn about us?
Your answer
Is there anything else that you would like us to know as we consider your application.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ScriptFlip!.
Report Abuse
Forms
