Application Form for Coaches, Counselors, Mentors, and Therapists

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Application Form for Coaches, Counselors, Mentors, and Therapists

Application Form

Thank you for your interest in joining our mission-driven community. Please complete this application form with honesty and prayerful consideration. Your responses will be reviewed to ensure that all applicants align with biblical values, ethical standards, and the mission of Amplify the Kingdom.

Personal Information

First Name(Required)

Middle Name

Last Name

Email Address(Required)

Phone Number(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Street Address(Required)

City(Required)

State(Required)

Zip(Required)

Country(Required)

Preferred Language(Required)

Faith & Alignment

1. How Did You Hear About Us? (Check one)(Required)

Friend/Referral

Social Media

Church/Pastor

Online Search

Other

Please specify(Required)

2. Agreement with Our Mission, Vision, & Core Values

Our Mission

"Empowering believers worldwide through Spirit-led discipleship, innovative technology, and transformative media to advance the Kingdom of God."

Our Vision

"To be the leading global platform that unites faith, technology, and community, equipping believers to grow spiritually, discover their purpose, and impact every sphere of influence for Christ."

Our Core Values

The Bible is verbally inspired by God and is the only written revelation from God to man. It is infallible and the authoritative rule of faith and conduct for mankind. (2 Timothy 3:15-17, 1 Thessalonians 2:13, 2 Peter 1:21)
Jesus Christ is God the Son, the second person of the Trinity. He is 100% God and 100% man, born of a virgin, lived a sinless life, performed miracles, died on the cross for mankind, and rose on the third day. He ascended to the right hand of the Father and will return in power and glory.
One God exists eternally in three persons: Father, Son, and Holy Spirit—co-equal and co-eternal.
Salvation is by grace through faith in Jesus Christ, not by good works or human effort. His death, burial, and resurrection provide the only path to redemption.

Do you fully agree with our mission, vision, and core values?(Required)

Yes

Please explain(Required)

Professional & Personal Background, Skills, Credentials & Experience

1. Ministry & Professional Expertise

What is your primary area of expertise or ministry? (Check all that apply)(Required)

Teaching & Discipleship

Worship & Music Ministry

Evangelism & Outreach

Digital Media & Content Creation

AI & Technology

Missions & Humanitarian Work

Other

Please specify(Required)

Which best describes your role? (Check all that apply)(Required)

Certified Christian Counselor

Licensed Therapist (Faith-Based)

Deliverance Minister

Spiritual Mentor / Coach

Other

Please specify(Required)

Years of Experience in Your Field(Required)

0-2 years

3-5 years

6-10 years

10+ years

Your Sphere of Influence, which best describes your area of expertise? (Check all that apply)(Required)

Family

Business & Economy

Health & Wellness

Government & Social Justice

Faith/Ministry

Arts & Entertainment

Media

Education

Science & Technology

Which areas do you specialize in? (Check all that apply)(Required)

Addiction Recovery

Prayer & Intercession

Grief & Trauma Healing

Inner Healing & Deliverance

Marriage & Family Counseling

Spiritual Growth & Discipleship

Business

Prayer & Intercession

Entreprenurial

Marketing & Media

Other

Please specify(Required)

2. Credentials & Qualifications

Do you hold any relevant degrees, certifications, or ministry credentials? (Please list or upload proof if applicable)

List any degrees, certifications, or ministry training

Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 5 MB.

Upload supporting documents (if applicable)

Accepted file types: pdf, doc, docx, jpg, jpeg, png, xls, xlsx, ppt, pptx, Max. file size: 5 MB.

Are you currently licensed? (If applicable)

Yes

Not applicable

Please upload proof of license

Accepted file types: pdf, jpg, jpeg, png, doc, docx, Max. file size: 5 MB.

Do you have a church or ministry affiliation?(Required)

Yes

Name(Required)

Faith & Approach

Describe your faith journey & how you came to know Christ (250 words or less)(Required)

How does your faith influence your coaching, counseling, or therapy practice? (250 words or less)(Required)

Background & Integrity Check

Have you ever been involved in activities contrary to Christian ethics (e.g., fraud, abuse, or misconduct)?(Required)

Yes

Please explain(Required)

Are you willing to undergo a background check if required? (For leadership or sensitive roles)

Yes

Availability & Service Structure

How do you offer services? (Check all that apply)(Required)

1-on-1 Virtual Sessions

In-Person Sessions

Group Coaching / Counseling

Online Courses or Workshops

Prayer & Deliverance Ministry

Other

Please specify(Required)

Do you charge for your services? (Check one)(Required)

Yes, I have a set rate.

Yes, I accept donations or sliding scale payments.

No, I provide services voluntarily.

Provide details below if applicable.(Required)

If you charge, what is your rate range? (Optional)

What is your general availability? (Days/Hours per week)(Required)

Commitment & Next Steps

How would you like to contribute to this platform? (Check all that apply)(Required)

Volunteering/Mentorship

Teaching/Training

Content Creation

Event Planning

Prayer Support

Other

Please specify(Required)

Are you committed to upholding biblical principles and values in your engagement with this platform?(Required)

Yes

As you’ve heard the vision and heart behind what God is doing through this mission, what do you sense the Lord is leading you to do next in partnering with us—whether that’s prayer, financial support, hands-on involvement, or something else? (250 words or less)(Required)

Vetting & Agreements

References

Please provide 1-2 references who can vouch for your work.

Reference 1

Name(Required)

Phone

Reference 2

Name(Required)

Phone

Upload Supporting Documents (Optional but Recommended)

Resume or LinkedIn Profile

Accepted file types: pdf, doc, docx, Max. file size: 5 MB.

Proof Any license or Certification (if applicable)

Accepted file types: pdf, jpg, jpeg, png, doc, docx, Max. file size: 5 MB.

Statement of Faith Agreement (Please check to confirm agreement.)

I affirm that Jesus Christ is my Lord and Savior, and my practice is rooted in biblical principles and values.

I commit to upholding ethical and professional integrity in my interactions with Amplify the Kingdom.

I understand that Amplify the Kingdom reserves the right to remove professionals who do not align with its mission or values.

Agreement & Submission

By submitting this application, I affirm that the information provided is true and that I align with the mission, vision, and core values of this platform. I understand that my application is subject to review and approval.

Terms And Conditions

I agree to the terms & conditions

Upon submission, our team will review your application and follow up within 7-10 business days. If selected, you will receive onboarding materials and an invitation to create your profile in the directory.