Coaching Certification Program
A SheRecovery Program | Live Course + Groups | Enroll by February 20, 2026
Full Name
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First Name
Last Name
Phone Number
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Can you receive texts on this phone number?
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Yes
No
E-mail
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Confirmation Email
example@example.com
Address to ship 90 Days to Wholeness paperback (ships to United States and Canada only). Allow up to 14 days for delivery.
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Application
Please Describe Your Role(s)
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Coach
Counselor
Student (College)
College Leader
Church Leader
Lay Church Leader
Ministry Leader
Other, please define
What was your highest level of education attained?
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High school diploma or GED
Some college
Associate degree
Bachelor's degree
Master's degree
Professional degree
Doctorate
Other, please define
Please select your age range:
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18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65-74 years old
75 years or older
Are you currently or have you ever been in recovery yourself?
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Yes
No
I prefer not to say
Please briefly describe why you are seeking this certification and what you hope to achieve with it?
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What questions would you like to have answered by this certification program? Your questions may help to shape some of the content, so it is good to ask!
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What are some of your concerns or insecurities about being a part of this certification program?
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Since this is a faith-based training, please describe your own faith. What is your relationship with God like? In what ways have you/do you use your faith in service to others? If not applicable, please type N/A.
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Is there anything else you would like to add?
Terms & Agreement
By submitting this application you are agreeing to the following terms. Please read carefully and check the individual boxes to agree to the terms.
I agree to all terms as outlined below:
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I understand the required live course will take place on Tuesday, March 3, 2026 from 11:00am-4:00pm CDT (includes 30 minute break).
I understand that each process group will be held from 11:00am-1:00pm on March 17, 2026, March 31, 2026, April 14, 2026, April 28, 2026, May 12, 2026, and May 26, 2026. Adjustments to the schedule will be communicated with adequate warning.
I understand that if I am unable to attend the live course and all process groups, I may forfeit my certification and without refund. If extenuating circumstances apply, they will be considered on a case by case basis.
I understand much of this course is shared from a faith-based (Christian) perspective.
I understand that men are welcome to take this course, it is not advised that men work individually with women.
I understand no CEUs will be awarded for participating in this program though a certificate of completion will be provided.
I understand since this is a pilot program, it is not yet accredited.
Payment & Payment Plans
Select Payment Plan
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Payment Plan (Weekly)
Initial payment of $80 due today, then 12 weekly auto-payments of $85 on Mondays starting March 9, 2026.
$
85.00
Payment Plan (Monthly)
Initial payment of $275 today, then monthly auto-payments of $275 on March 3, 2026, April 3, 2026, and May 3, 2026.
$
275.00
Pay in Full
Payment due in full now.
$
1,100.00
Credit Card Details
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