Application to become the QMindness Coach

Please provide information to be considered as a coach for the QMindness professional development platform that enhances the well-being of researchers and academics. 

What QM provides to a coach:

  • High check customers = large organization customers, long-term collaborations.
  • Infrastructure/organizational work is covered, i.e. placement of your profile on the website, advertising, newsletters.
  • The team and the joint creative space for coaches in order to develop new workshops / masterclasses / field sessions, etc. and more! 

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First name *
Last name *
Email *
Phone number
City and country of residence *
Coaching language(s)
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Coaching experience (starting from month/year)

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Coaching certification (school & ACSTH, ACTP)

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Coaching accreditation (ACC, PCC, MCC)

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Research experience: position, years, field

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About personality & coaching style

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What services would you like to provide? (e.g. individual or group coaching sessions, workshops/masterclasses, other services/topics?)

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Existing own programs/workshops (yes/no and name of product)

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Today's date *
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Hereby, I give my consent to Dr. Alevtina Evgrafova (hereinafter – “QMindness”) to process my personal data, specifically, my first and last name(s), phone number(s), e-mail address(es), home or business address(es). I give my consent to the Coach to perform the following actions with my personal data: data entry into the spreadsheet and storage of this spreadsheet on electronic devices belonging to the Coach, including storage on cloud drives belonging to the Coach (in this case access for unauthorized persons to the folder where this spreadsheet is located must be restricted), usage of my personal data in order to make a decision on the application as a coach and information being placed on the website www.qmindness.com in case being selected. This consent is valid and is in force indefinitely. I may withdraw this consent at any time by sending a written notification to the Coach. *
Required

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