Application Form
INFORMATION AND INSTRUCTIONS FOR APPLICANTS
Associate Coaching Course (ACC) | Professional Coaching Course (PCC)
Please view our website for more information, outlines, brochures, dates, prices and payment terms of each course
before applying for our courses www.centreforcoaching.co.za
Please complete all required fields marked with a *. Other fields are provided in order for us to have a better
understanding of who is attending each course and allows us to prepare for the course with all your circumstances in
mind. Please ensure that you send back all pages of the application form.
Contact the Centre for Coaching
Centre for Coaching (Pty) LTD
UCT Graduate School of Business
Breakwater Campus, Portswood Road, Waterfront 8001
Tel:
+27 (0)21 406 1031/1493
Fax:
E-mail:
[email protected]
Website:
+27 (0)21 406 1484
www.centreforcoaching.co.za
Deposits and Fees: :(Please ensure you place your reference number on your Proof of Payment OR your Name and
course e.g. JBrownCTE2013 on the payment)
Bank Details:
Name: Centre for Coaching (Pty) Ltd
Bank: Nedbank Foreshore
Account number: 1083342754
Branch code: 108309
ACC 2017 Deposit amount: R7,000
Please see brochures for full fee information
PCC 2017 Deposit amount: R11,000
Checklist for your application
Please ensure that you include the necessary documents when sending in your application form:
☐ Complete the application form – for PCC, please submit no later than application the closing date.
☐ Send a digital head-and-shoulders photo of yourself (JPEG).
☐ Pay the non-refundable deposit - proof of payment to be included with your application form.
Additional for Associate Coaching Course (ACC) Applicants ONLY:
☐ Send your Motivation Letter - ACC Only: in which you describe your purpose in taking this
course and what you hope to accomplish (maximum 1 page)
Additional for Professional Coaching Course (PCC) Applicants ONLY:
☐ Complete the Associate Coaching Course.
☐ Send your completed Pre-course Questions essay: click here to download.
Please note:
 That your application MUST be submitted no later than the closing date (PCC).
 Any late applications may be reviewed but only AFTER the applications received timeously have been
considered.
 That our courses are limited in the number of students we can accommodate per course. We operate on a
strictly first-come, first-served basis. Places will be kept once complete application and deposit (proof of
payment) has been received. Once the class total number is reached, students will be put on a waiting list and
be notified as we receive an opening.
 Please ensure you review our strict cancellation policy on Page 4
COURSE DETAILS
Which course are you applying for? Further details on fees & deposits please refer to our website.
Cape Town
Johannesburg
Start date
ACC - Associate Coaching Course (6 months)
PCC - Professional Coaching Course (1 year)
Not available
APPLICANT DETAILS
*Surname
*First Name/s
Preferred Name
*E-mail address (for all correspondence)
*Physical Location (for group meetings)
* Postal Address (incl. postal code)
These meetings usually take place after hours.
Area or Suburb:
☐Work ☐Home
Home Telephone Number and Code (incl. country &
*Mobile Phone Number (incl. country code if
area code if outside of SA)
outside of SA)
Relationship Status
No. & Ages of Children (if applicable)
I.D Number
*Date of Birth
*Educational background: Qualifications and Institutions Attended
Have you completed any Centre for Coaching or New Ventures West courses?
Course Name
Year:
Facilitator:
Where did you hear about the Centre for Coaching? Have you attended a coaching roundtable?
Do you have any Special dietary requirements?
Do you have any disabilities of which we need
to be aware?
**Please note that arranging certified Halaal or Kosher Meals may incur a small additional fee
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CURRENT EMPLOYMENT INFORMATION
*Name of Company
*Your current position/job title
Core business / industry (e.g. Transport,
Education)
Work Telephone Number and Code (incl. country
and area code if outside of SA)
Number of years with this company
Your department
Duties (brief job description)
In what types of situations do you (or would
you) use coaching?
What is your experience of coaching people or being coached?
* INVOICING DETAILS
Please advise how this account will be settled:
☐ Individual
☐ Company sponsored
If company sponsored please provide us with contact details of the person responsible for payment in your
organisation:
Company Name:
Finance Contact Name:
Finance Contact E-mail:
Invoicing Address:
Postal
Code
VAT Registration No.:
Purchase Order No. if
required:
Do you require an invoice before the deposit can be paid? ☐Yes ☐No
Deposit
Please note that there is a deposit amount for each course to reserve your space, this amount is non-refundable and
non-transferable. Please ensure that you include your Proof of Payment with you application form.
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Cancellation Policy:
The ACC is a popular programme and each year we have a waiting list of highly committed applicants. Your spot is one
of only a few available each year and we need to implement a strict cancellation policy to ensure that all participants
are sure that they have carefully thought through the personal, time and financial commitments that are required in
order to be able to complete this world-class, rigorous course.
 More than 30 days before the course start date qualifies for a refund of the fees less the deposit amount.
 30 to 14 days before the course start date is subject to forfeit of 50% of the full fees.
 14 days prior to the course start date results in a forfeit of 100% of the full fees.
If balance payment has not yet been made, the programme fee becomes immediately due and payable.
Cancellations must be made in writing via Email.
Acknowledgement of Understanding:
I hereby confirm that I am applying for the above course and agree to pay the course fees in full
and attend all session dates outlined in the course brochure.
I understand and agree that if I withdraw from the course less than 14 days prior to
commencement, or at any stage after commencement, results in 100% forfeiture of the total
course fee. Any portion of the fee unpaid then becomes immediately due and payable.
* ☐ I hereby acknowledge that I have read the cancellation policy and accept these as terms of
my application.
Full Name
Signed at
On the
Day of
20
Signature
Applications to be submitted by the closing dates to:
[email protected]
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