E-Learning Application

Please complete and submit the below application to be considered for registration on to our e-learning program.

Note - you may find it useful to draft your answers on a seperate word document which you can save and edit before copying and pasting your answers in to the required fields of the application form.

Once we have received your application we will contact you to let you know if you have been accepted on to the program.

Please see our privacy statement before completing this form. All information is kept private and handled in accordance with the Data Protection Act 1998.

1. My E-Learning Registration
2. Your Full Name(required)
3. AddressFull postal address including postcode(required)
4. Telephone(required)
5. Mobile(required)
6. Email(valid email required)
7. Prefered Means of Contact
8. Post Email Mobile Telphone
9. 1, Health - Good health is a key philosophy of Walking Coach
10. 1.1 What state is your health (physical + mental) and how do you feel about it?(required)
11. 1.2 Maintenance - how do you maintain your health?(required)
12. 1.3 Concerns - what concerns (if any) do you have about your health?(required)
13. 1.4 Energy - how would you describe your energy levels?(required)
14. 2. Coaching Experience - Please provide details of your qualifications, level and date attained.
15. 2.1 Qualification - please list relevant qualifications, level of qualification, date attained and awarding body.(required)
16. 2.2 CPD - how do you maintain your level of knowledge and continual professional development?(required)
17. 2.3 Ethics - explain how you ensure you protect the needs and welfare of your clients?(required)
18. 2.4 Skills - what techniques, models & approaches to coaching do you use and how do you decide which you draw upon with a client?(required)
19. 2.5 Coaching - How many hours per week do you currently coach?(required)
20. 3. Interests
21. 3.1 Motivation - why are you interested in the Walking Coach and how do you feel you will be able to maximize on its concept fully?(required)
22. 3.2 Interest - are you interested in a Walking Coach Regional Licence ?
23. Yes No
24. 3.3 Plan - if yes, how would you go about establishing the Walking Coach in your region?
25. 4. General Information
26. 4.1 Employment Status
27. Full Time Employed Part Time Employed Self Employed Retired Other
28. 4.2 Other InformationPlease detail any other information you consider is relevant for us to know about.
29. 5. References - please provide details of two references.
30. 5.1 Reference One(required)
31. 5.2 Reference Two(required)
32. Thank you for your registration. Please click submit and we will be in contact once we have considered your application.

 

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