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Coach Application

To apply to the Cannabiziac Expert Network program, you must meet certain eligibility requirements on this form. Please complete and submit along with any supporting documentation such as your head shot photo and resume. If you have any issues submitting this form, please contact [email protected].

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Prospective Coach Information

First Name

Last Name

Company/Organization

Title/Position

Street Address

City

State

Zip

Office Phone

Mobile Phone

Email

Date of Birth (mm/dd/yyyy)

Education

Highest Degree Earned

High School Diploma Associate Degree Bachelors Degree Master Degree Doctoral degreePost Graduate Degree Other Degree Received

Other Related Licenses and Certificates

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Language Proficiency

EnglishSpanish Creole/French Other

Other language(s)

Professional Role

Job Title

Business Name

Website

Entrepreneurial Experience

How long have you been in business?

Current Position

Duration (Years/Months)

Position 2

Duration (Years/Months)

Position 3

Duration (Years/Months)

References

Reference Name 1

Reference Phone 1

Reference Email 1

Reference Name 2

Reference Phone 2

Reference Email 2

Reference Name 3

Reference Phone 3

Reference Email 3

Have you ever started a business?

YesNo

If Yes, when?

Are you currently an entrepreneur?

YesNo

Have you worked with a startup other than your own?

YesNo

If so, what was your role?

Have you worked with an organization that supports entrepreneurs?

YesNo

If so, what was your role?

Are You Currently A Member Of Cannabiziac?

YesNo

Please Upload Your HeadshotPlease do not upload your logo. Upload a recent headshot only. Allowed: jpg, png, pdf (Max size 7.5 MB total)

Upload

Resume & BioPlease provide your Resume (dating back minimum 10 years) and bio telling us about yourself. This can include your business, that is your current professional role, prior experience, education, personal interests, etc. Your answer will appear on our website as you have entered it here. Allowed file format: pdf, docx

Upload

Other Areas Of Expertise(Additional Skills - Separate With Comma Between Skill)

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Do you have international business experience or a global reach? If so, please explain and include what countries.

Please add your social media URLs.

Instagram (Ex. instagram.com/johndoe)

Facebook (Ex. facebook.com/johndoe)

Twitter (Ex. twitter.com/johndoe)

LInkedin (Ex. linkedin.com/in/johndoe)

Coaching Approach & Opportunities

Cannabiziac wants to ensure we’re recruiting the best and most knowledgeable, reputable global cannabis industry experts. Please complete the questions below as we learn more about you and your expertise.

Why do you want to be a coach/consultant with Cannabiziac? *

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Please share more about your coaching experience. What has been successful? What has been challenging?*

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Which of following coaching opportunities are most interesting to you?

Professional Occupation

Professional Occupation in the Cannabis Industry (if applicable)

Please list any other specific topics and/or services you’d like to offer coaching.

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What Are Your Pricing Options?

What Are Your Rates?

Availability Type

VirtualIn-PersonWeekdaysEveningsWeekendsAll of the Above

Demographic Information

Our mission is to have an inclusive global ecosystem, please complete the demographic information below for us to better understand who engages with our organization and members and to track our diversity, equity and inclusion practices.

Racial Identity

Other: please specify

Age Group

Do Any Of The Following Apply To You? *

Other: please specify

Preferred Pronouns

How Did You Hear About Cannbiziac?

TERMS AND CONDITIONS

I'm willing to sign a confidentiality agreement.

Yes

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First Name

Last Name

Email