DCA® Divorce Coach Certification Application

Name*

First NameLast Name

Email*

Confirmation Emailexample@example.com

Phone Number (please note format)*

Country Code (leave blank for US)Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal/Zip CodeCountry

Tell us a little about yourself. Are you currently employed? What do you do for fun?:*

0/200

Do you currently hold any professional credentials or designations?*

0/100

What is the primary reason you are interested in becoming a certified divorce coach?*

0/200

What are you most looking forward to learning in the program?*

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Describe any personal or professional experience you have with divorce:*

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If you've had your own divorce experience, describe how you feel emotionally prepared to safely engage with others having similar experiences. What makes you ready to coach from your scar and not from your wound?

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What strengths will you bring to your clients? What's the secret sauce that will make you an effective divorce coach following certification?*

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How do you believe an alternative dispute resolution approach to divorce benefits individuals and families?*

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YesNoNot Sure

YesNoNot sure

Is there anything else you would like us to know or consider when reviewing your application for admission?

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How did you hear about DCA's ADR Divorce Coach Certification program?*

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Please upload a photo

Please read and check the box below to indicate your agreement:

I understand that representatives of Divorce Coaches Academy® LLC will review my application and may contact me at the email address provided.
By submitting this application, I certify that all information is accurate and any included professional designations or credentials are current.
I understand that Divorce Coaches Academy's approach to divorce coaching is grounded in the principles of alternative dispute resolution. DCA® supports emotional management, flexible thinking, interest based negotiation and values based decision making as foundational to creating a kinder, gentler divorce process for individuals and families.
I have reviewed the program requirements and am committed to investing the time and effort necessary to complete my certification.
All application and tuition fees are billed in USD at the current exchange rate and international currency charges may apply. Check with your credit card company for information on international transactions if you have questions.
DCA® reserves the right to deny or defer my admission to the program.
Once enrolled in the program, tuition and fees are non-refundable 14 days after start of the course. Should you choose to drop the course, cancellation requests must be made in writing before the end of the second week of class.

Submission Date

Date

Signature

We're excited to receive your application and are looking forward to your personal admissions interview so we can get to know you a bit better and tell you more about the program.

Welcome to the revolution!