Application CPDC Student (2025)

2025 Certified Professional Diversity Coach

Session 1, 2, 3 + Virtual Practicum = 128 hours

Tuition $8,897 + Application Fee $100 non-refundable

Practicum Hours Include: Virtual Labs, Writing Assignment, Peer and Mentor Coaching

Upon acceptance into the program, your initial payment of $2,897 is due.
Training Program*

Certified Professional Diversity Coach
Select Location*

In-PersonVirtual (Zoom)
Virtual Dates (Zoom)*

Jan 29-31 + Mar 26-28 + May 7-9Feb 26-28 + Apr 9-11 + Jun 25-27
In-Person Dates (Washington, DC)*

Feb 19-21 + Apr 23-25 + Jun 4-6
Name*

PrefixFirst NameLast Name
Email*
If you decide to purchase hard copies of the workbooks, we will send you the workbooks one week before class starts. Please provide the best address for you to receive a package.
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone*

Area CodePhone Number
Which of the following best represents your race or ethnic heritage?*

WhiteBlack, Afro-Caribbean or African-AmericanLatino or HispanicAsian or Pacific IslanderMiddle Eastern or ArabNative American or Alaskan NativeOther
Pronouns*

He / Him / His.She / Her / Hers.They / Them / Theirs.Other
Highest Level of Education Completed*
Which of the following best represents your religious affiliation?*

BuddhistCatholicChristian (non-specific)HinduJewishMormonMuslimProtestantSikhNon-Christian FaithNoneNo AnswerOther
Work History*

0/1000
Why Did You Choose CoachDiversity Institute?*

0/1000
Briefly tell us why you want to be a certified coach.*

0/1000
How do you rate yourself in the following areas:

Self-awareness*

	1	2	3	4	5

1 is Worst, 5 is Best

Active Listening*

	1	2	3	4	5

1 is Worst, 5 is Best

Emotional Intelligence*

	1	2	3	4	5

1 is Worst, 5 is Best

Being Non-judgmental*

	1	2	3	4	5

1 is Worst, 5 is Best

Openness to Learning New Things*

	1	2	3	4	5

1 is Worst, 5 is Best

How do you hope to grow through the program?*

0/1000
Describe your current professional and career goals*

I want to start my own coaching practice.I want to become an internal coach at an organization.I want to enhance my professional development.I want to use coaching skills in my therapy / counseling practice.Other
Who referred you?*

Application Fee$100.00

OPTION: Workbooks (hard copies)$90.00

Virtual students can receive hard copies of the workbooks by mail.

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