Apply to Enroll in the Mental Game Coaching Professional Certification

MGCP CANDIDATE APPLICATION

Please complete the following application for consideration of enrollment into the Mental Game Coaching Professional (MGCP) certification program. Completion of this application does not guarantee enrollment but is used to identify qualified candidates. Applicants will be notified of acceptance into the program and then will be asked to complete the enrollment forms for the program. If you have any questions, contact Dr. Cohn at 888-742-7225.

Name:
Address:
City:	State: Zip:
Phone:	Cellular:
Fax:	Email:
Gender:	Age:
Current Profession:
Current Job Position:
Title:
Select MGCP Course:
Do you have access to athletes you can work with during the program?
What day and time do you prefer to meet via phone each week? *all times are EST
Sport Background (In the space below, please provide a short history of your experiences in sports as an athlete, coach, or therapist.
Reason for Becoming a Mental Game Coach (In the space below, please provide a statement about why you would like to incorporate mental coaching with athletes).
Professional Qualifications In the space below, please add your resume. If you would rather, you may fax your resume to 407-909-1789. Please be sure to indicate on your fax that you are applying for the MGCP certification program. Check this box ONLY if you will be faxing your resume.
Are you a member of any professional organizations (e.g. AAASP or APHERD)? If so, what?
Have you ever attended or participated in any form of mental game coaching or sports psychology training? If so, where/when?
How did you hear about the MGCP program?
If accepted into the MGCP program, when would you like to begin the course?