CCLC Renewal Form 2024

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Please complete the form, then hit "Submit" at the end.

Your renewed CCLC certificates will be emailed within 2 weeks of completion. You will receive your certificate from Terri Straka (exec-admin@ca-ministries.com). If you have any questions or trouble with this form, please reach out to Terri for assistance.

If you are renewing your CLC -

please let Terri know in comments AND if it's ok to be listed on our CCLC Directory.

First and Last Name *

Name on Certificate (if different)

Phone Number (this is not shared) *

Complete Mailing Address (snail mail) *

City and State FOR WEBSITE (if different from mailing)

Email Address (will be posted on website) *

Continuing Education Completed *

None Required; I have taken 6 or more CAM courses to date (verification may be required). SKIP the next two questions.

CAM 500-level coaching course. Please answer the next two questions.

Group Mentor Coaching (GMC). Please answer the next question.

Participation in The Coaching Exchange. Please answer the next question.

Required

Start date of your continuing education option

YYYY

If you checked a CAM 500-level course, please select one. Otherwise, skip this question.

To pay your $75 renewal fee, please click link: CCLC Renewal Online Payment This will open a new window in your browser. After payment, close the payment window and check "paid" in the space below. Then hit SUBMIT.

THANK YOU!!

Paid

Required

Any comments or questions? (Or are you renewing your CLC?)

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