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
Which program are you applying to?*

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

0/200
What is the highest level of education you have achieved?

High school or high school equivalent2 year degree4 year undergraduateMaster'sDoctorateOther
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?*

0/200
Describe any personal or professional experience you have with divorce:*

0/200
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?

0/200
What strengths will you bring to your clients? What's the secret sauce that will make you an effective divorce coach following certification?*

0/200
How do you believe an alternative dispute resolution approach to divorce benefits individuals and families?*

0/200
How soon are you interested in beginning your divorce coach training?

ASAP1-2 months3-6 months6-12 monthsA year or more
Are you able to commit to approximately 90 minutes of video learning, 30 minutes of written exercises, and one live 90-minute Zoom call per week for the learning portion of the program?*

YesNoNot Sure
Are you able to commit approximately 90 minutes per week for 9 weeks to fulfill the mentor coaching portion of the training?*

YesNoNot Sure
Are you willing to embrace a learning mindset, fully participate, and be open to feedback during the program?*

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

0/200
How did you hear about DCA's ADR Divorce Coach Certification program?*

0/50
Please upload a photo

Cancelof
Please read and check the box below to indicate your agreement:
1. I understand that representatives of Divorce Coaches Academy™ LLC will review my application and contact me at the email address provided to schedule a personal admission interview.
2. By submitting this application, I certify that all information is accurate and any included professional designations or credentials are current.
3. 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.
4. A non-refundable $75 application fee is due with submission of this application and covers processing costs and your personal admission interview. Once admitted to the program, this fee will be deducted from the remaining program fee which must be paid to confirm your enrollment and reserve your spot.
5. Any promotional or coupon codes can be entered and will be applied at the time the program fee is paid - they are not valid toward your application fee.
6. I have reviewed the program requirements and am committed to investing the time and effort necessary to complete my certification.
7. DCA™ reserves the right to deny or defer my admission to the program.
SCHEDULE YOUR ADMISSION INTERVIEW:

If we haven't met for an information session or met previously, please schedule a one-on-one meeting via one of the links below or reach out to us at DCA@divorcecoachesacademy.com to arrange an alternate time.

> Schedule a General/US Interview

> Schedule an Australia Interview

Check the Box to Pay Your Application Fee *

DCA™ Divorce Coach Certification Application FeePayment is required at time of application in order for an admission interview to be scheduled. (coupon codes are valid for enrollment fees, they cannot be applied to your application fee)

$75.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Submission Date

MonthDayYear
Date
Signature

Clear
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!
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

> Schedule a General/US Interview

> Schedule an Australia Interview