Application Form CIHC

Application instructions for CORPORATE INTEGRATIVE HEALTH COACH TRAINING PROGRAM

Applicants will be notified via email within 48 hours and may be asked to schedule a brief telephone interview with Dr. Nickerson.
Any information you share via this website is private. For more information, please read our full privacy policy.
By submitting this application, you are under no obligation to enroll in the program.

Legal NameStreet Address CityState/Province, Zip/Postal CodePhone Number (where you prefer to be contacted, if needed)Email AddressBirthdate Education (please include your field of study)Previous Experience (list only those roles that are relevant to becoming a Corporate Integrative Health Coach)Tell us why you are interested in becoming a Corporate Integrative Health Coach. What is your goal for taking this program? What would you like to get out of it?How will you apply this training professionally?What profession do you presently work in?If you are part of a group purchase, what organization do you work for?How do you best like to learn? (Visual, auditory, reading? Group discussions or individual?)How did you hear about this course?If approved, what date do you intend to start the course?Today's Date

By submitting this application, I confirm that the information given in this form is complete and accurate.

Thank you! Your submission has been received. You will be contacted within 48 hours.

Oops! Something went wrong while submitting the form.

Application Form

for the Corporate Integrative Health Coach Training Program

Application instructions for CORPORATE INTEGRATIVE HEALTH COACH TRAINING PROGRAM