3 Vital Questions ®

Certified Trainer Application

Applicant's Information

First Name *

Last Name *

Shipping Address *

Shipping Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Mobile Phone Number *

Country *

Your City, State, and Country will be provided to other 3VQ Trainers and will be posted on our website. If you would like something different listed than your shipping address, please provide that here.

Email Address *

Company Name *

Title *

How did you hear about the 3VQ Certification Training? If referred by someone, please write their full name. *

Experience

What is your field of work? *

What is your depth of experience with TED*® and the 3VQ frameworks? Check all that apply: *

Desired Outcomes

What attracted you to this certification? *

What are you hoping to gain by becoming a 3VQ Certified Trainer? *

In your wildest dreams, how would you like to share the 3VQ work with others? *

Internal Coach	External Coach
Trainer	HR
OD	Therapist/Counselor
Team Leader	Other Other

Receive the weekly essay	Read the book(s)
Taken a live workshop	Taken a previous webinar
Taken the eCourse	No previous experience, looking to learn more