Application for HypnoCoach® Certification
Hello and thank you for your interest in becoming a Certified HypnoCoach®! I originated my HypnoCoach methods and process in the early 90's when most people didn't even know about 'personal coaching'. Since then, I've trained hundreds of hypnotists around the world to use my methods with their clients. Since HypnoCoach is a U.S. Registered Trademark, I'm literally 'putting my name' on you when you qualify to graduate. So the first step is to know a bit about you before you join the class.

Please note - this course does not teach basic hypnosis techniques and all applicants should already have completed certification and training comparable to the standards of the National Guild of Hypnotists training.

I will be in contact soon after receiving your application. Thanks!
~Lisa Halpin DCH, BCH, CI, OB
888-497-8416
HypnoCoaching@gmail.com
www.HypnoCoachCertification.com
www.HypnosisDistanceInternship.com

Complete First and Last Name *
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Email *
Please indicate business or personal and feel free to include both
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Phone (include area code) *
Please indicate cell, office or home and fee free to include all three
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Distance Course, East or West Coast training location? *
Please indicate where you'd like to attend 4 days of live HypnoCoach® class - there will additional 'homework' after you return home from class.
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Mailing address *
Please indicate home, office or both
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How were you referred to my HypnoCoach® Certification training? *
Where you referred by a HypnoCoach® graduate, have taken other classes with me, found via website or youtube, know me from the National Guild of Hypnotists... please let me know how you found me.
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Zoom contact ID *
If you don't use Zoom enter 'none'
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Skype contact ID: *
If you don't use Skype enter 'none'
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How long have you been a certified hypnotist or hypnotherapist? *
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Where/from whom did you receive your original hypnosis certification and training? *
Please indicate: Name of Instructor, Hypnosis School, Certifying body (NGH, ABH, MDHA etc) and location (city, state, country)
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How many hours of training and what mode of interaction was included? *
Please indicate: Total number of hours and duration (for example: 10 days = 75 hours live training + 25 hrs homework)
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List additional relevant certifications and training (hypnosis, EFT, NLP, coaching, etc.) *
Please indicate dates, instructor and/or school name and title of certification or training
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List additional education and qualifications or licensing *
Please indicate as you would on a resume: Date, school, degree, major, etc Also indicate any license such as RN or MFT etc.
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Please tell me why you want to be Certified HypnoCoach® and how/why this training can benefit your clients and yourself. *
Please share with me your interest and passion regarding why you'd like to join the ranks of my Certified HypnoCoach grads! And anything about how/why you feel especially qualified to add HypnoCoaching to your practice.
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Is there anything else you'd like to share with me?
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Would you like me to contact you for a free phone consultation about becoming a HypnoCoach®? *
Please let me know your best days and times for availability.
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Note
The term “HypnoCoach” is a U.S. Registered Trademark (®) of and the intellectual property of Lisa G. Halpin. All derivatives of the term (-ing, -es, etc.) are covered by this trademark as are any confusingly similar terms including the use of lower case letters or a hyphen. Any use of the term or derivative without proper authorization from the trademark holder may result in legal action. Certification is not guaranteed merely by attendance in or payment for the course. Only upon successful completion of my HypnoCoach® Certification course including all class hours, additional practicum, final exam, assessment by the instructor, and signing the authorized use licensing agreement will the Certified HypnoCoach® designation and physical certificate be awarded.
I have furnished true and complete answers in the above questionnaire and wish to apply to be included in a training class for HypnoCoach® Certification. *
Please 'sign' by typing your full name in the box below and date this application further below
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