Online Application Form for Private Commercial Training Organisations

Applying to join the IRCM’s Education Directory as:*

Organisation Name*

Organisation Address*

Building number/name Street name City County / State / Region ZIP / Postal Code Country

Main Contact:

Name*

Prefix First Middle Last Suffix

Position held in the organisation:*

Email*

Your email address will only be used to contact you in relation to your Directory entry. If your email address changes, please email registers@IRCM-CIC.org with updated details.

Telephone*

Your telephone number will only be used to contact you in relation to your Directory entry.

Private Commercial Training Organisation

Legal Entity Name*

Legal Entity Structure*

https://en.wikipedia.org/wiki/List_of_legal_entity_types_by_country

Legal Entity Reference*

For example, if your company is a Private Limited Company in the UK, you would enter your Company Registration Number.

Date Legal Entity started trading:*

DD

MM

YYYY

Legal Entity Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Was the organisation trading prior to this legal entity structure?*

Organisations original trade/Legal Entity name:*

Please enter the organisations original trading or legal entity name.

Please enter the following dates:*

1. enter the date this organisation started to trade in its initial format/Legal Entity structure
2. enter the date this organisation changed from its initial format/Legal Entity structure to the current Legal Entity structure.

Date format: DD/MM/YYYY

1. started to trade	2. changed from its trading structure to the current trading structure

Insurance: does this Legal Entity have business/professional indemnity insurance?*

Please provide your insurance policy details:*

Date formats - DD/MM/YYYY

Organisation name	Insurance Type	Certificate Number	Date issued	Date expires

Professional Body accreditation/credential*

Is your organisation accredited/credentialed by one or more Professional Bodies?

If not, please explain the reason(s).*

If yes, please provide the following detail.*

Professional Body Name	Accreditation/Credential Grading

If yes, please list which courses/workshops are independently verified in your accreditation/credential status and what grading was awarded.*

If it was only the organisation accredited/credentialed, please enter 'NONE' on the first row.

Course/Workshop Name	Accreditation/Credential award	Date awarded

Other Directory entry details:

'CONTACT ME' button on your Directory page*

Please enter the details which will allow consumers to contact the organisation. In the 'preference' field please enter which you would prefer to use - website or email address.

Website	Email address	preference

Description - Please enter a short focused description of the Private Commercial Training Organisation.*

Logo

All logos must be .JPG or .PNG.
No less than 300 DPI.
Square in shape (no less than 500 pixels by 500 pixels)

Course/Workshop details:

Date organisation started courses in coaching and/or mentoring:*

DD

MM

YYYY

Coach and/or Mentor training:*

Courses and/or Workshop details:*

Qualification Name	Course or Workshop	Formal Education qualification level	Qualification is recognised by these initials	Coach training only, Mentor training only, or Coach and Mentor training	Number of (1) years, (2) months, or (3) hours.	Brief outline description

Other Information

Additional Information

Declarations:*

Our organisation agrees to include and abide by the IRCM’s Unified Code of Industry Ethics.

*

Our organisation agrees to include and abide by the IRCM’s United Industry Core Competencies.

*

Our organisation agrees to include and abide by the IRCM’s Disciplinary Procedures.

*

Our organisation agrees to recognise the coaching and mentoring industry Ombudsman Service.

Application Fee:*

Please select the relevant option.
On receipt of your fee, your Directory entry will be created within 24-48 hours.

How did you hear about the IRCM?*

If you were introduced to the IRCM by a person, please enter their name. If not, please provide the details as to how you found the IRCM. Thank you.

*

I confirm that I am the person listed under ‘Main Contact’ above and by submitting this form, I confirm that, on behalf of this organisation, I am applying for the organisation to become Registered or Listed (as selected above) with the IRCM and give authority for the information submitted on this form and through other communication methods is to be shared on the IRCM Directory for Education.