THE INSTITUTE OF LEADERSHIP AND MANAGEMENT

CERTIFICATE AND DIPLOMA IN LEADERSHIP MENTORING AND COACHING

APPLICATION FORM

Please check entry requirements
Please check programme dates - Certificate and Diploma
Required fields are indicated by *

Programme*
Programme start date*
 
Title*
Name*
Job title*
Organisation*
Registered charity No.

Contact address

 
Invoice address
if different
Line 1*
Line 2
Line 3
Town/City*
Postcode*
Telephone number*
mobile
e-mail address*
 

Information required by the ILM for registration and equal oppotutities monitoring. You also need to agree that we can register you with the Learning Records Service if you are not already registered. This is simply a data protection issue but it is a prerequisite of ILM registration. For more information see here.

Date of birth*
Ethnic origin*
LRS registration*
Disability*

Please give details of any previous qualifications in leadership, coaching, management or HRD*

Please give a brief description or your role and responsibility*

What are your objectives in attending this programme? What are you personal learning goals?*

What impact are you expecting to achieve in your organisation as a result of attending the programme? How will you measure this?*


Do you have any special requests you would like to let us know about (such as dietary, mobility etc.)


Terms and conditions

I have read and accept the terms and conditions

On submitting the application you will be directed to an acknowledgement page and should receive a summary of the form by e-mail to the address you provided. If this does not happen please contact us.
All applications are vetted to ensue that they meet the ILM criteria. Successful applicants will be contacted within seven days.