SMDCN Coach Application

SMD Network Coach Application
Criteria to be a SMD Network Coach:
1. Provide credentialing certificate for AG Coaching at a minimum AGCC Level One Coach in good standing or minimum ACC credentialed coach in good standing with the ICF.
2. Complete SMD Coaching Network application.
3. Be AG affiliated/active with AG church/district. (Do not have to be credentialed minister to be SMDCN coach.)
4. Provide pastor recommendation if not ordained minister.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Number

Area CodePhone Number
Office Number

Area CodePhone Number
E-mail*
Assembllies of God Affiliation:
Church:*
How affiliated?*
How long?*
District/Section*
How affiliated?*
How long?*
Position:*

Lead PastorStaff PastorPastor's WifeCredentialed MinisterDistrict OfficialLay Person
Can we list your name and email address on the 'Find a Coach' page of our website?*

YesNo
How do you want your name listed?
Example: John Doe AGCC1
If not ordained minister: Attach recommendation letter from your pastor.
Coaching Credentials:*

AG Coaching Certification: Current certificate attached.ICF Coaching Certification: Current certificate attached.No coaching certification attached.
If no coaching certification is attached, give reason why and when we can expect to receive a copy.
INSTRUCTIONS:

Email application and all attachments to: lisasmdag@gmail.com.
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SMD Network Coach Application