Application form: RETAIN Parental Leave Coaching Certification
Email *
First Name *
Last Name *
Phone Number *
What is your best contact email? *
Share a link to your professional website or social media: *
Where are you in your coaching journey? *
Tell us about your experience and educational path - both formal (what degree(s), or trainings, do you have) and informal (life experiences that have helped form you). *
Approximately how many new or expecting parents do you work with in a year? *
What is your primary area(s) of focus right now? *
Do you currently have a product or offering for new and/or expecting parents? If so please describe what that is and how your work is structured. *
Why do you want to be a RETAIN Parental Leave Coach? *
How did you learn about the RETAIN Parental Leave Coaching certification, the Center for Parental Leave Leadership, and/or Dr. Amy Beacom? *
Did you know we offer a Parent-It-Forward Scholarship?
Q: What is the Parent-It-Forward Scholarship?

A: The Parent-It-Forward Scholarship is our way of making sure everyone who wants to become a certified RETAIN Parental Leave Coach can do so. In the spirit of the Pay-It-Forward movement, Dr. Beacom has seeded an initial cohort scholarship for those who have need.

Because one of our core values at CPLL is to lift-all-boats and put a hand out to help lift others as we rise, we ask our scholarship recipients to pledge some portion of their future RETAIN Coaching earnings to this scholarship fund to ensure future participants can benefit as well. CPLL is also committing a percentage of yearly profits to the Parent-It-Forward Scholarship.

We firmly believe that all parents deserve support, no matter how they became parents, their gender identification, race, geographic location, job role, income, religion, political perspective – diversity is what makes our shared world rich and meaningful. We use this scholarship to actively ensure this value-based goal is achieved.

You can indicate in the next few sections whether you would like to contribute to, or apply for, the Parent-It-Forward Scholarship.
I would like to contribute to the RETAIN Coaching Parent-It-Forward Scholarship Fund:
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Parent-It-Forward Scholarship fund note:
Our Parent-It-Forward Scholarship is designed to allow those who otherwise couldn't become RETAIN Certified, to do so. While we want to make RETAIN Certification available to everyone who is interested, we also know the value people place on something (and subsequently the effort they put into something) is tied to its price. This is a truth you will find in your future coaching work as well.

With that in mind, please think creatively about ways for you to fund your certification and consider where you are willing and able to stretch financially to contribute to your own learning and development. If you determine that you need financial support to be able to attend, let us know below what that amount is (note: we do offer a pay-over-time plan as well).

We can not guarantee we can meet your need, but we do guarantee to be open and work in partnership with you to try to make it happen.

If we are not able to offer support at this time, would you like to be considered for future cohorts?
I would like to apply to receive support from the RETAIN Coaching Parent-It-Forward Scholarship Fund at this time (or for a future cohort if I am not accepted into this cohort).
Clear selection
Please use this space to describe the amount of scholarship you need to receive from the RETAIN Coaching Parent-It-Forward Scholarship Fund in order to join this cohort. Feel free to include anything else you would like us to know to consider your request with a full picture of your situation.
If you are not accepted into this pilot cohort, would you like to be considered for our next cohort? *
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