ICR COACH REGISTER
CERTIFICATION & REGISTRATION FOR PROFESSIONAL COACHES
APPLICATIONFORM ICR COACH REGISTER V.SEPTEMBER.2015
INSTRUCTIONS & NOTIFICATIONS
1. Please complete this form.
2. Forward the completed form together with the compulsory documents to our
office by email [email protected] or WeTransfer.
3. Find the overview of the compulsory documents under 8.
4.
This form together with the compulsory documents makes your personal registration
and certification file. If a file is incomplete or if one or more documents are declined
the registration and certification will be put on hold or rejected.
5.
We forward your registration & certification invoice per email. If the invoice is
(partially) not paid your certificate(s) will be suspended or revoked. The status
‘revoked’ or ‘suspended’ is visible at our website.
6.
Questions?
Contact our office per email at [email protected].
7.
Your official and personal registration and certification application statement:
I AGREE
My email message or WeTransfer is my online signature.
By forwarding this form I contemporaneously agree with the following:
I AGREE
1. Herewith I apply for the registration and certification.
I AGREE
2. I will pay the once-only costs and annual registration fee.
I AGREE
3. ICR coachregister is a subsidiary of Global Network Group (GNG).
Our general conditions apply and are published at our website.
I AGREE
4. Global Network Group has my full and unconditional permission to publish
my business, registration and certification details in the public GNG registers
and to make these details available for GNG accredited agencies.
I AGREE
5. Global Network Group has my full and unconditional permission to register all
my personal and business details in the companies non-public and
confidential databases.
I AGREE
6. I comply with all registration and certification documents, guidelines,
regulations and rules.
ICR COACH REGISTER | P.O. BOX 5530 | NL 6802 EM ARNHEM | NETHERLANDS
Phone: +31(0)88 0038 745 | Email: [email protected]
© 2015 | ICR COACH REGISTER
PAGINA 1 VAN 5
| Internet: www.icr-coachregister.com
Global Network Group (GNG) is ISO 9001:2008 certified by Lloyds
Register (RQA663058). ADR Register, EMCI Register, ICR Coach
Register & IHR Register are subsidiaries / registered trade names
of Global Network Group (Chamber of commerce RDAM
56601506).
ICR COACH REGISTER
CERTIFICATION & REGISTRATION FOR PROFESSIONAL COACHES
APPLICATIONFORM ICR COACH REGISTER V.SEPTEMBER.2015
8. Overview compulsory documents
DOCUMENT
ASSOCIATE
FULL
compulsory
compulsory
compulsory
compulsory
Proof of company registration with an official authority, such as: chamber of commerce,
OR any other authorized proof of company existence.
compulsory
compulsory
Copy certificate(s) of general education | required: higher education or university or
demonstrable and verifiable similar thinking, knowledge and skills level
compulsory
compulsory
Copy certificate of education / training | required: ICR accredited scope related basic
professional training or training.
compulsory
compulsory
n.a.
compulsory
compulsory
n.a.
n.a.
compulsory
compulsory
compulsory
n.a.
compulsory
Application form
Curriculum vitae | required: ICR scope related CV
Application for full certified: the experience audit is based on your CV, more proof of
evidence might be required.
Copy certificate skills test | required: ICR accredited scope related skills test
Two (2) letters of recommendation OR Two (2) letters of nomination
The referent needs to recommend you for the associate registration & certification.
Two (2) letters of recommendation issued by clients
The client supports your application for the full registration & certification.
Letter of good conduct OR statement ‘no criminal records and history’ issued by an official
governemental authority, such as the ministry of justice, a police commandant, a mayor.
Proof of valid liability insurance polis
ICR COACH REGISTER | P.O. BOX 5530 | NL 6802 EM ARNHEM | NETHERLANDS
Phone: +31(0)88 0038 745 | Email: [email protected]
© 2015 | ICR COACH REGISTER
PAGINA 2 VAN 5
| Internet: www.icr-coachregister.com
Global Network Group (GNG) is ISO 9001:2008 certified by Lloyds
Register (RQA663058). ADR Register, EMCI Register, ICR Coach
Register & IHR Register are subsidiaries / registered trade names
of Global Network Group (Chamber of commerce RDAM
56601506).
ICR COACH REGISTER
CERTIFICATION & REGISTRATION FOR PROFESSIONAL COACHES
APPLICATIONFORM ICR COACH REGISTER V.SEPTEMBER.2015
REGISTRATION AND CERTIFICATION REQUEST
PLEASE MARK YOUR CHOICE
REGISTRATION & CERTIFICATION SCOPE
ASSOCIATE
FULL
ICR INTERNATIONAL CERTIFIED COACH®
ICR INTERNATIONAL CERTIFIED BUSINESSCOACH®
ICR INTERNATIONAL CERTIFIED CHILDCOACH®
ICR INTERNATIONAL CERTIFIED INHERITANCE-COACH®
ICR INTERNATIONAL CERTIFIED NLP-COACH®
ICR INTERNATIONAL CERTIFIED PSYCHOLOGIST-COACH®
ICR INTERNATIONAL CERTIFIED LANGUAGE-COACH®
Interested in registration and certification for professional arbitrators,
mediators and negotiators?
 These services are offered by ADR Register.
 ADR Register and ICR coachregister are subsidiaries of Global Network Group.
 Website: www.adr-register.com
 Landline: +31(0)88 0038 777
 Email: [email protected]
ICR COACH REGISTER | P.O. BOX 5530 | NL 6802 EM ARNHEM | NETHERLANDS
Phone: +31(0)88 0038 745 | Email: [email protected]
© 2015 | ICR COACH REGISTER
PAGINA 3 VAN 5
| Internet: www.icr-coachregister.com
Global Network Group (GNG) is ISO 9001:2008 certified by Lloyds
Register (RQA663058). ADR Register, EMCI Register, ICR Coach
Register & IHR Register are subsidiaries / registered trade names
of Global Network Group (Chamber of commerce RDAM
56601506).
ICR COACH REGISTER
CERTIFICATION & REGISTRATION FOR PROFESSIONAL COACHES
APPLICATIONFORM ICR COACH REGISTER V.SEPTEMBER.2015
REGISTRATION DETAILS ICR COMPANY | !! COMPLETE ALL FIELDS !!
OFFICIAL NAME
IF APPLICABLE:
TRADE NAME(S)
PHYSICAL ADDRESS
ZIPPCODE
PLACE
COUNTRY
POSTAL ADDRESS
ZIPPCODE
PLACE
COUNTRY
LANDLINE
WEBSITE
EMAIL
REGISTRATION NUMBER COMPANY
COMPANY OFFICIALLY REGISTERED WITH
ICR COACH REGISTER | P.O. BOX 5530 | NL 6802 EM ARNHEM | NETHERLANDS
Phone: +31(0)88 0038 745 | Email: [email protected]
© 2015 | ICR COACH REGISTER
PAGINA 4 VAN 5
| Internet: www.icr-coachregister.com
Global Network Group (GNG) is ISO 9001:2008 certified by Lloyds
Register (RQA663058). ADR Register, EMCI Register, ICR Coach
Register & IHR Register are subsidiaries / registered trade names
of Global Network Group (Chamber of commerce RDAM
56601506).
ICR COACH REGISTER
CERTIFICATION & REGISTRATION FOR PROFESSIONAL COACHES
APPLICATIONFORM ICR COACH REGISTER V.SEPTEMBER.2015
REGISTRATION DETAILS ICR PROFESSIONAL | !! COMPLETE ALL FIELDS !!
OFFICIAL ACADEMIC TITLES
INITIALS
INFIX & NAME
PHYSICAL ADDRESS
ZIPPCODE & PLACE
COUNTRY
POSTAL ADDRESS
ZIPPCODE & PLACE
COUNTRY
LANDLINE
WEBSITE
EMAIL 1
EMAIL 2
CELLPHONE
GENDER
DATE OF BIRTH
PLACE OF BIRTH
COUNTRY OF BIRTH
NATIONALITY
ICR COACH REGISTER | P.O. BOX 5530 | NL 6802 EM ARNHEM | NETHERLANDS
Phone: +31(0)88 0038 745 | Email: [email protected]
© 2015 | ICR COACH REGISTER
PAGINA 5 VAN 5
| Internet: www.icr-coachregister.com
Global Network Group (GNG) is ISO 9001:2008 certified by Lloyds
Register (RQA663058). ADR Register, EMCI Register, ICR Coach
Register & IHR Register are subsidiaries / registered trade names
of Global Network Group (Chamber of commerce RDAM
56601506).