Facilitator Application Form

Please note: You will be contacted only if we have a specific need for your skill set, but your application will be maintained in our active file for one year.

GENERAL INFORMATION

Title

First Name

Last Name

Designation (i.e. Ph.D.; C.H.R.P.; P.M.P. etc)

Company

Job Title

Address Line 1

Address Line 2

City

Province

Postal Code

Business Phone Number

How did you learn about becoming a CMC Facilitator

Please specify referral source

Please provide the url to your website

Attach your chronological Resume or CV

One file only.
13 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

EXPERTISE & PROFESSIONAL EXPERIENCE

Area of Interest

Area of Interest (Secondary)

Industries you have experience working in (press CTRL key to select more than one value)

Other

EDUCATION

Institution

Degree

Year

Institution

Degree

Year

Institution

Degree

Year

Institution

Degree

Year

Professional Certifications (ie. Coaching, MBTI, CHRP, etc., please separate each certification using the enter key):

Relevant Books/Articles Published (separate each item with enter key. Include copyright dates)

Language Skills (press CTRL key to select more than one value):

Other

Please indicate the top five CMC courses you are interested in delivering (please separate each course by using ENTER key)

ADULT LEARNING & FACILITATION EXPERIENCE

Facilitation Experience - Audience Level (press CTRL key to select more than one value)

Instructional Design Experience (press CTRL key to select more than one value)

Relevant O.D. Experience (press CTRL key to select more than one value)

Experience with instructional Instruments (press CTRL key to select more than one value)

Other experience with instructional instruments not listed

ONLINE FACILITATION EXPERIENCE

Online Facilitation Experience (press CTRL key to select more than one value)

Please indicate the last time you delivered an online training session

Other Online Experience not listed

Online Platform experience (press CTRL key to select more than one value)

COACHING EXPERIENCE

Do you provide coaching as part of your professional services

Yes

Coaching Experience – Coachee level (Press CTRL key to select more than one value)

How many coaching hours to you conduct annually

Search

Facilitator Application Form

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