|
Membership:
Both the membership of ICF Global and that of ICF Nederland are renewable annually.
Please fill out this form. Fields marked with (*) are compulsory.
You will receive instructions for payment.
|
| PERSONAL INFORMATION |
| Mr / Mrs |
Mr
Mrs
|
| Name (*) |
|
| Surname (*) |
|
| Home Address |
Post Code
City
|
| Office Address (*) |
Post Code (*)
City (*)
|
| Website |
|
| Email (*) |
|
| Telephones: |
| Home |
-
|
| Office (*) |
-
|
| Mobile |
|
| PROFESSIONAL PROFILE |
Education:
School / University (place, title, year) / Coach training place (title, year)? |
|
| Work - what do you do? |
|
Most coaches started doing something else before they became coaches. Please give a short summary of your past working experience
|
|
| What kind of coaching do you do? (life wellness, corporate, career, etc) |
|
| What kind of clients do you like working with? |
|
| COACHING EXPERIENCE |
| Do you have a coach certification? |
Yes
No
|
| School you graduated and year |
|
| ICF certification? |
Yes
No
|
| If yes, which level and year? |
ACC
PCC
MCC Year
|
| If not, do you intend to obtain an ICF certification? |
Yes
No
What level and year?
|
| Why are you a member of ICF? |
|
| Are you a member of any other similar organisation? |
|
| If you intend to be an active ICF Nederland member, how do you see your contribution? |
|
| Would you like to give a workshop for our members? If yes, on which subject? |
|
YOUR WEB PROFILE
You can choose to have a profile on our website. It will be part of the
"Search for a Coach" database that potential coaching clients can access.
You can choose to complete your profile in Dutch, English or both languages.
It will be posted in the language/s you have chosen. The costs associated
with this service are Euro 35,00 excl. VAT. This amount will be added to
your annual membership of Euro 90,00 excl. VAT. |
| What kind of coaching you specially do? (Choose only three) |
Business / Entrepreneurship coaching
Executive / Corporate coaching
Mentor / Coaching for coaches
Career coaching
Life coaching
Other
|
| |
DUTCH |
ENGLISH |
| Your elevator speech (what you say if someone asks you what you do) - max of 200 words: |
|
|
| Give any other information you would like prospects to know about you: |
|
|
SUBSCRIPTION TIJDSCHRIFT VOOR COACHING
Below you can indicate whether you are interested in an annual subscription
to the Tijdschrift voor Coaching (written in Dutch) at a reduced rate of
Euro 21,00 excl. VAT per annum. This rate gives you a discount of 53%
compared to the normal price.
Yes, I would like an annual subscription at a reduced rate
No, I would not like an annual subscription at a reduced rate |
| PICTURE: After sending this form, please send a photograph to post in your web profile to: webmaster@icf-nl.org . |
|
|