1. Adler International Learning
Admission Application
(To complete the registration process, fill in this Admission Application AND the Course Registration form)
CONTACT INFORMATION:
First Name: Last Name:
Street and Number: Apartment:
City, Province, Postal
Code: Country:
Home Phone: Business Phone:
Personal E-mail : Business E-mail:
BACKGROUND INFORMATION:
Professional Background - Please list last 3 positions held, starting with most current.
TITLE ORGANIZATION FROM –TO (year)
Educational Background - Degree/Certification/Diploma
INSTITUTION FIELD OF STUDY DEGREE/DESIGNATION YEAR
YOUR CURRENT PROFESSIONAL FOCUS – Check as many as apply
Sales & Marketing Finance/Accounting Therapy/ Counseling
Human Resources Information Technology Operations
Training & Organizational Medical/Health Services Government
Development
Other (please specify)
Effective November 6, 2007 Page 1 of 2 ASPC0001 – Admission Application

2. MORE ABOUT YOU (Please answer all the questions below)
Please mention any other Certifications, life experiences, activities or achievements that have
given and/or give you joy, pleasure or satisfaction:
 Where did you learn about the Program?
Information Evening From an Adler Alumni or Student Internet At work
OISE University of Toronto
Other (please specify)
 A you currently coaching as part of or all of your professional activity?
Are
Y
YES NO
 If “YES”, describe briefly:
 What are your personal learning objectives for your Coaching Education?
(Select all those that apply)
To learn more about Coaching
To support current coaching activities with formal education
To gain pre-requisites for specialized or advanced coaching programs
To gain more insight into myself and grow personally
To become Certified
Other (please specify)
 Please check area(s) of specialization with greatest interest for you:
Executive and/or Business Coaching Team Coaching Life Coaching
Relationship Coaching General interest mainly
Other (please specify)
Thank you for helping us understand more about you so that we can address your needs and interests throughout the Program.
Please fill out the Course Registration Form to complete the application process.
Effective November 6, 2007 Page 2 of 2 ASPC0001 – Admission Application