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IMGCA Certification Application

  This is the form for applying for IMGCA Certification by mail, with payment by check. If you prefer to pay online using your credit card or PayPal account, go to our Online Certification Application Form.

Please print this page or copy it into your word processor, then fill it out and mail or fax it to IMGCA. (See below for address and fax number.) Please include a check for your $100 application fee, payable to IMGCA. This fee will be applied to the certification course charges if accepted into the program. $75 of the fee is refundable if the applicant is not accepted.

A star to the left of an item indicates a required entry.

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  Name ______________________________________

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  Address _________________________________

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  City, State, Zip _____________________________
    Country _________________________________

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  Phone __________________________________

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  Email address ________________________________
    Website ________________________

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  Check certification level desired:
  _____ Level I Certified Mental Game Instructor
  _____ Level II Certified Mental Game Coach
  _____ Level III Certified Mental Game Master Coach
  _____ Level IV Certified Mental Game Professional Coach
  _____ Level to be determined after consultation

Refer to IMGCA Certification for prices and additional details.

    What are your motivations and reasons for wanting to be certified by the IMGCA?







    Please describe your background as an athlete, mind-body disciplines, or in movement. Include all activities you have participated in, and the various levels, with specific examples of achievements.





    If you are not a coach or teacher, and may qualify for candidacy under the other categories listed, please describe your background in sports, physical education or other mind-body disciplines. Include all disciplines you have been involved with, how you have been involved and the various levels, with specific examples of achievements.





    Describe your training, coursework or background in the mental game field. How are you currently applying mental game coaching principles to your work?







Privacy notice:
The information submitted on this application is used only for IMGCA purposes. At no time will we share any of this information with any other person or company.

 
Procoach Systems IMGCA International Association of Coaches

The International Mental Game Coaching Association
1523 Alma Terrace, San Jose, California 95125, USA
Phone: 408-294-2776, Toll-free: 888-445-0291
Fax: 408-298-9525
BCole@MentalGameCoaching.com
www.MentalGameCoaching.com

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