Thank you for your interest.
Please read each of the following 3 documents.

Reading only the ones that apply to your interest and after
reading the appropriate documents, check the box above
each to indicate that you have read and
understand their content.

COACHING CERTIFICATION
THREE LEVELS OF COACHING CERTIFICATION

COACHING CERTIFICATION
STATEMENT OF PURPOSE & MISSION

COACHING SESSIONS
ONE - ON - ONE PERSONAL, BUSINESS AND / OR HEALTH COACHING

PLEASE COMPLETE EACH AND EVERY FIELD IN THE FORM BELOW
All information is kept confidential and is used for the beginning of your
coaching certification program or your personal, business and / or health coaching sessions only!

First Name         

Last Name         

Email Address    

Phone Number   

Address             

City                    

State / Province 

Zip Code            

Country              

Please tell us why you want to become a certified coach and / or why
you want to enroll with Doctor Doug White, PhD. in his one - on - one coaching sessions.