Your Corner Coaching Application Thank you for your interest in joining our community as a Coach! Please fill out the form below and we will be in touch Contact Information * First Name Last Name Email * Phone * (###) ### #### What are your license type(s)? * Clinical Social Worker (LCSW, LICSW, LISW, etc.) Marriage & Family Therapist (LMFT, LCMFT, LIMFT, etc.) Mental Health Counselor (LMHC, LCMHC, LMHP, LPMHC, etc.) Professional Counselor (LPC, LPCC, LCPC, etc.) Psychologist Other I am not a licensed therapist In which state(s) are you licensed? * Enter your license number(s) * What are your coaching credentials? * ACC PCC MCC NBC-HWC BCC CMHC Other I do not have any coaching credentials. Please share the experience you have in a coaching capacity. * In just a few short sentences, please describe your coaching style and methodology. * As a Coach, which subject areas are your greatest specialties? * Choose your top 3-5 Anger Management Burnout Career & Workplace Challenges Confidence Decision making Insecurity Loneliness Marriage Issues Mindset Physical Health Challenges Racism & Discrimination Relationship Conflict Resilience Self-care Sexual Health Sexual Orientation & Gender Identity Sleep Issues Stress Work-life balance Which of the following superpowers sounds most like you? * Incredible Listener Amazing Motivator A+ Actionable Advice Calm, Cool, & Collected Coach Accountability! Your Biggest Fan & Cheerleader Why are you interested in coaching on Your Corner? * Optional: Any feedback/thoughts on how we can improve the Your Corner model to better support coaches and clients Thank you!
