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Western Coaches Referral Network Application

"I would like to participate in the Western Seminary Coaching Referral list. I understand that this does not constitute an endorsement by Western Seminary, but simply a recognition that I have completed the Western Seminary coach training program of course 1 - 4."

Instructions: Please complete all fields and submit. Your application will be reviewed and you will be notified by email prior to the information being listed on the Westerncoaches.net website. If you have any questions, please contact Norm Thiesen at nthiesen@westernseminary.edu.

Request for Listing
First Name: Middle Initial
Last Name:
Title: Dr Rev Mr Mrs Ms (Optional)
Degree: (If you desire to have a degree listed)
Contact Phone: - - (Where you want to be contacted)
Web Address:
Contact Email:
Contact Address:
City:

State:
Zip:
Additional Training / Comments:
Yes, I would like to offer my coaching services pro bono to a student enrolled in a course with the Western Seminary Center for Lifelong Learning.

I affirm that I have successfully completed 60 hours of coach training
at Western Seminary

      Seminary Credit Certification
Terms and Conditions
  1. I hereby affirm that I am in agreement with the faith statement of the National Association of Evangelicals.
  2. I agree that 10% of my practice will be either no fee or low fee. Low fee is defined as coaching costs of less than $50 a month for your normal services.
  3. I agree that I will keep Western Seminary informed and/or timely response to Western Seminary inquiries for information.
  4. I agree that I will not state or imply that I am employed, represent or am endorsed by Western Seminary except as authorized by the Seminary.
  5. I agree to follow the code of ethics for coaches as stated in the ICF ethical guidelines.

    Note: Any lack of compliance of the above or any other situation that might reflect negatively on Western Seminary will cause your name to be removed from the list.