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Coach Training Fellowship Application

Please copy and paste this entire application into a word document and send it to  



1. Basic Info


First name you prefer:





Postal Code:





2.  Phones


Home Phone:

Work Phone:

Mobile Phone:

At what number can we most easily reach you over the next few days?



3. Email/Web


Email Addres:

Other Email Address:

Web Site(s):





4. Confidentiality


Do you agree to keep entirely confidential the class bridge

number, all emails shared on the class list serve,

information shared by others in the program, including
your homework partners, as well as the Foundations
Manual and class materials themselves?




5. Commitment


Please answer succinctly: As a Fellowship Winner, would

you treat the program as if you had paid $1000 for each

class, taking the program and each class very seriously?

This would range from doing your best to be present

at every session, to completing class homework and

projects, to taking out-of-class action (based on your

discretionary time available) to build a coaching





6. Interest in this Coach Training Fellowship


For a great overview of the program, see our Executive 


The Foundations Program is described in the eleven
screens starting 
here. Please tell us why you are
interested in adding coaching as a professional
specialty and why you areinterested in MentorCoach


How might coaching fit with your larger professional plans

for the next decade?


Please be frank and concise.




7. Previous Coach Training


Please describe any coach trainingcourses you
have had to date including the coach training

organization and instructor.




8. Financial Need


The fellowship is intended for readers of the ABDSG
with financial need that would otherwise preclude them from

taking this training. Write a succinct paragraph on your

level of financial need. 




9. Administrative Fee


The tuition (that will be waived) for this program varies based
on the payment method. The total tuition can vary from US $2360
($295/month for 8 months) to US $1995 if prepaid.


But for the Fellowship Winner, the tuition is waived.

There is a single administrative fee of $295.


Are you willing and able to pay a fee of US $295 to

cover administrative costs for your participation in the





10. Current day job(s)


What is/are your current day job (s)? How are you now supporting

yourself?  We are interested in recruiting, not only applicants
in their 20's but mid-life professionals who have significant
responsibilities in their current work. 




11. Previous Professional Work Experience


Outline your past work experience.




12. Academic Program


If relevant, in what University, program and department are (or were) you enrolled?

What is your area of specialty?




13. Academic Training and Specialty


What's your academic training to

date? What is your area of specialty?



14. Willingness to Volunteer


The fellowship is limited to students who have the willingness to
volunteer some time on a flexible basis over the next year.  

This work can be done "virtually", from any location in
the world with a telephone.  And it can be flexibly tailored to
fit your schedule.

Would you be willing to volunteer your time and expertise to help our community?




15. Your Availability for the the MCP 199 Foundations Program.


The time of the MCP 199 program works for me.



MCP 199 Mondays
31 Mondays
12:00 pm - 12:59 pm Eastern (New York Time)
Starts Monday November 16, 2015*
Stephen Coxsey, LPC, PCC
All information here

*If necessary, you can begin with the second or third class.



16. Your Availability for the the MCP 200 Foundations Program.


The time of the MCP 200 program works for me.



MCP 200 Thursdays
31 Thursdays
8:00 pm - 8:59 pm Eastern (New York Time)
All Time Zones
Starts Thursday December 10, 2015
Pat Hinton Walker, PhD, PCC
All information here 




17. Are you available to join either Foundations class?

(Note: it's a plus if you are flexible and are willing to
attend either class.)


I'm able to attend either MCP 199 or 200.



My FIRST preference would be__________

My SECOND preference would be__________.


I have no preference. 





18.  The Train Is Leaving the Station!

That's it.  Now, time is of the essence. The train is leaving
the station.

This application does not have to be perfection itself.  We
are much more interested in learning who you are than in
the style of the application.  If you are interested, fill
this out and submit it right away!  We'd love to have you
join us.


Best wishes,





Ben Dean, Ph.D.

P.S.  For questions, you can reach us at 301-986-5688 or




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