Volunteer Coaches Application
for Life's Headwaters.
A 501(c)3 not for profit private operating foundation.
Thank you for your interest in coaching people to successfully
navigate life transitions. We have an open request for coaches at all times.
After you hit submit on this form, please note the page you are brought to
as it contains important instructions on
your next steps to complete the volunteer process!
If you are volunteering in another capacity
note that in the comments section.
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Telephone:
Alternate Telephone:
Fax:
Your Coaching Website:
Are you an accredited
coaching school graduate:
Select One Yes No Pending
School Name:
Date of Graduation:
Hours coaching (paid):
Hours coaching (pro-bono):
Coaching niche(s):
Preferred client age group:
Select One 16 - 24 year old 25+ year old All of the above Other - lets talk
Select as many as desired One to One Coaching - Phone Tele-seminars Group Phone Coaching Workshop - In Person Speaker Other not listed
If selecting more than one, hold down your control key and highlight each selection
Member of ICF:
Yes No
Member of IAC:
Professional Certification Level:
Select One None Coaching School Graduate Pending PCC ACC MCC Other, please list
Highest Level of Education Completed:
Select One High School Graduate AA/AS BA/BS Vocational Certificate Professional Degree MBA/MSW/MA/JD/PhD Other not listed
Your time zone:
Eastern Central Mountain Arizona Pacific
Hawaii/Alaska Other not listed
Do you agree to a criminal background check?
Select One Yes No Let's talk
Do you agree to abide by the
ICF Code of Ethics for Coaches?
Describe your ideal volunteer coaching assignment:
Are there other skills or strengths beyond your coaching that you would be willing to donate time and talent in? If so please list.
If you want a record of your application,
please print your screen before you submit your information.
