Life Coach Application

First Name

Last Name

Gender

Date of Birth

Nationality

Ethnicity

Language

Telephone Number

Mobile Number

Residential Address

Street Line 1

Street Line 2

City / Suburb

State / Province

Country

Postal / Zip Code

Postal Address

Postal Box / Street Line 1

Street Line 2

City / Suburb

State / Province

Country

Postal / Zip Code

Company Name

Trading Name

Registration No.

VAT No.

Type of Business

Industry

Years in Business

Number of Branches

Number of Employees

Number of Permanent Staff

B-BBEE Status (South Africa Only)

Annual Turnover

Telephone Number

Mobile Number

Website URL

Business Address

Street Line 1

Street Line 2

City / Suburb

State / Province

Country

Postal / Zip Code

Postal Address

Postal Box / Street Line 1

Street Line 2

City / Suburb

State / Province

Country

Postal / Zip Code

Business Stage

Idea/Concept Stage Start-Up Phase Growth Phase Established Phase

Business Description (500 char max)

Instagram

Facebook

TikTok

YouTube

Logo - Hi Res

Company Profile - One-Pager

Shoulder Image of Yourself - Hi Res

Company Team Image - Hi Res

I agree to the Terms and Conditions.

I agree to the Privacy Notice.

I/We confirm that I/We are duly authorized by the above mentioned Company to make this electronic application for Membership as an authorized signatory. I/We hereby make application for Membership of the International Chamber of Entrepreneurship & Trade as a juristic person, representative of the abovementioned organisation and not as an individual.

If elected, I/We will observe and be bound by the rules, regulations and by-laws of the said Chamber as may be in operation during the term of My/Our membership.

I/We understand that the membership of the Chamber is ongoing and can be cancelled by written request, giving 30 days' notice.

I, hereby agree to the terms of this application. I have read and understood the terms of this application form.

By clicking SUBMIT, I agree that all the information included in this application is true and correct.

Date

Only members of Good Business Standing are recognised by Our Chamber and we pride ourselves in only having legitimate and credible members who adhere to Good Business Practices.