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IMGCA Certification Application
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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 _____________________________ |
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Country _________________________________ |
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Phone __________________________________ |
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Email address ________________________________ |
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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.
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What are your motivations and reasons
for wanting to be certified by the IMGCA?
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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.
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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.
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Describe your training, coursework
or background in the mental game field. How are you currently
applying mental game coaching principles to your work?
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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.
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