M11-T01-D04.1
 M09-T04-D04.1

RGB Certification Online Application

Name: 

Telephone:       e-Mail (REQUIRED):

Address:

I have read, understand and agree to, if Certified, abide by the contents therein:
  Official Positions within the Quality of WorkLife Consultants Structure.
  CapacityWare^TM Technology and Software User License Agreement.
   CapacityWare^TM Technology - QWLC Standards of Conduct.

And...

  I request enrollment in: Foundational Workshop study leading to a Certified Practitioner status, and
     if requested complete the CapacityWare^TM Model Prioritization online study program based on the Survey submitted separately .

Initial work to be done as either an Internal or External Practitioner.

I have identified one or more potential facilitation partners who will work with me - YES, or NO.

Learning Materials are primarily attached to the online Transcript and Study Guide provided upon approval.

A Mentor may be requested from among those available:  Mentor Selection Options Lacroix, Joseph J.

Group Facilitation Experience Summary:

CapacityWare^TM Software processing preferences:
        Installed on my work/personal computer - Operating System:  XP, 7, 8 or 10.  Instrument processing fees (counters/licenses) apply.
        All input routed through QWLC for processing with Priority delivery.

Comments and/or Questions:

Tuition:  I will submit tuition requirements via: Check, PayPal - Credit Card (please send me an invoice), or using a Payment Plan Negotiable.  Payment can be made by check, or online through PayPal (credit card).  A Pay Pal selection will result in your receiving an invoice with online instructions.  Alternative payment plans are also available.  Conference discounts or Trial Offers apply for 30 days. 

Conference Offer:  None at this time.