Coach Information Form

Thank you for your payment. Your transaction has been completed, and a receipt for your purchase has been emailed to you.

Please fill out all the information on this form. We will review your application and get back to you within 24 hours. If you are approved your transaction will be processed.

While we appreciate hearing from all coaches, unfortunately we cannot accept all who apply to become an Associate. In that event, your money will be immediately refunded. We will not charge anyone who does not qualify.


First Name (required)

Last Name (required)

Email address (required)

Phone Number (required)

Skype ID (required)

LinkedIn URL


Where are you located? (required)

Languages Spoken (required)

I Offer Free Consultations (required)


I do Special Appearances


Year You Started Coaching:

Describe Your Coaching Experience (Press Crtl key on Windows or Command key on Mac) for multiple selections-Pick Only 3)

Professional Credentials, Associations, Education

Your Biographical Information (required)

We suggest you provide 1 or 2 testimonials from satisfied clients

List Corporate Clients or large organizations you have worked with.

Special or Promotion - Please provide the URL of any special or promotion on your website. We will include a Specials/Promotions tab on your coach profile with this URL link back to your website.

We suggest using a photo that will present you in the manner you prefer. Please do not use a closeup as the image will appear cut off at the top and bottom. We cannot resize your photo to change the perspective (required FORMAT: jpg or png MAXIMUM SIZE: 500px by 500 px)

The JMA Coach Network Client Promise (required)

"In the event of a client being dissatisfied with my coaching during the period covering the first 4 coaching sessions, I agree to refund any fees paid by the client up until that time. Recognizing that my behavior reflects on all coaches in this Network, I will deal with this in a professional and courteous manner. As an Associate Coach and for the benefit of all Associates, I agree to FEATURE ON THE FRONT PAGE OF MY WEBSITE THE NETWORK LOGO WITH A BACKLINK TO THE NETWORK'S MAIN PAGE."

Please Note: If your membership is approved, it will AUTOMATICALLY RENEW at the end of the period for which you are signing up unless you notify us otherwise.