I. Contact Information
Your full name (as you would like it on a business card)
Preferred title
The name of your organization or service (if applicable)
Street Address
Include street address in listing
Do not include street address in listing
City
Include city in listing (Helps clients know time zone and cost to telephone.)
Do not include city in listing
Province/State
Include province/state in listing (Helps clients know time zone and cost to telephone.)
Do not include province/state in listing
Postal/Zip Code (required)
Include postal/zip code in listing
Do not include postal/zip code in listing
E-mail address (required)
URL on WEB
Business phone (required)
Personal phone (optional)
Fax
Would you like your listing placed in alphabetical order using your last name or your business name?
Last Name
Business Name

How did you learn about this listing opportunity?

2. Connection to Professional Coaching Associations
To which of these organizations or associations do you belong?
The Peer Resources Network (Info)
The International Association of Coaches (Info)
The International Coach Federation (Info)
The Professional Coach and Mentors Association (Info)
The Worldwide Association of Business Coaches (Info)
The International Consortia of Business Coaches (Info)
The International Mentoring Association (Info)
Other
Specify organization(s) or association(s)

Not a Member

If not a member of one of the qualifying organizations listed, provide the name of the Code of Ethics to which you subscribe in your practice: (Why is this important?);

If you are not a member of an organization or association with a code of ethics and do not have a code of ethics specified on your website, then we recommend you join the Peer Resources Network as an alternative. (Note: Completing this form does not result in membership in the Peer Resources Network.)

3. Service Information
Describe your coaching service goals, mission, vision, or purpose; in other words, what you intend to accomplish with clients.

Describe the results you have typically been able to accomplish with clients (in other words, what are clients typically able to do as a result of working with you):

(Optional) What information can you provide about the fees you charge:

What qualifications, training, or unique experiences do you have or other accomplishments that would interest potential clients and impact on your credibility as a coach?

Which organizations or associations do you currently belong to that have a Code of Ethics pertaining to professional service in general or coaching in particular?

If you provide workshops, seminars, or lectures, please provide
titles, a brief description of content, future dates and places, costs,
and other relevant information (we will provide a link to your site
for most of the details and current schedule):

What else should we include in your listing that hasn't been covered:

What search terms can you suggest for potential clients to use to find your listing?

If you have a website and are willing to place a link on your site to our site, what is the URL for the page which will (does) contain the link to Peer Resources? When will this link be in place?

4. Conditions for Listing

• No offensive, objectionable, pornographic or illicit material can be placed on any page.
• No offers of services with potential outcomes that are illegal or violate human rights or dignity will be accepted.
• Peer Resources reserves the right to edit material for brevity, clarity, or format standard.
• Peer Resources reserves the right to determine the suitability of any listing, and can reject any listing that, in their opinion, does not match the quality, spirit and objectives of this service.
• Each listing person will be responsible for the accuracy of information provided and for submitting updated material as soon as available;
• Each listing person will guarantee that the information they provide for a listing is accurate and genuine, and represents a true and current description of the services provided;
• If requested, the listing coach will provide written documentation of any credentials, certificates, degrees or memberships stated in their listing;
• Each listing coach will periodically review his or her listing to ensure its accuracy and include up-to-date contact information;
• If a listing person has been convicted of criminal activity or has received disciplinary action by any professional or judicial body associated with providing services, a summary of such conviction or action must be stated in the application for listing (this will remain confidential);
• The listing person guarantees that the content of their listing does not violate any professional code of conduct, ethical principle, law, policy, or regulation governing their service area;
• Whenever possible the listing person will include as part of their listing any professional organizations, standards, or ethical principles they typically use or are associated with in their practice;
• The listing person must be a member of an association or professional organization that includes a published Code of Ethics or the listing person must include a published code of ethics on his or her own website (Why do we require this?);
• If a dispute occurs between the listing person and any client, the listing person agrees to have the dispute reviewed by a group of professional coach peers for resolution;
• The listing person must be able to typically respond to requests from potential clients within one business day; and
• The listing person must create a link to Peer Resources (www.peer.ca/coaching.html) on his or her web site and indicate the page that contains the link.
• Members of the Peer Resources Network (PRN) may submit any change to a Coach Directory listing at any time and are eligible to receive professional editing at no charge.

Return to the beginning of this application.

Yes, I have read and agree to the conditions as stated.
No, I do not agree to these conditions.

Please make sure you have read the conditions listed in Section 4, and have checked the Yes or No button at the end of that list before submitting your application.