GPA Initiative – Coaches – Health + Community Care Workforce Sector Council

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GPA Certified Coaches Workshop – Application

Important Details

To be completed by the Organizations GPA Facilitator Contact

Please note that registration on our website only grants pre-approval. Pre-approved applicants will receive a link to the AGE website, where they must complete the registration process for full approval.

Please ensure your applicants meet all the requirements to become a certified coach:

Completion of the GPA eLearning Program is a prerequisite for the GPA Coaches training;
100% attendance, participation, and successful completion of the Applied Practice Group Teaching segment;
3+ years of experience in dementia care, geriatric care, or a related field;
Experience in coaching, teaching, or facilitating;
Job role includes an ongoing relationship with GPA Education Session Participants;

The organization and applicants agree to participate in an evaluation process related to this project.

*Please note that each organization may sign-up a maximum of 2 employees per program (e.g., per GPA Certified Coaches Workshop event)

Facility/Agency Information

Facility/Organization Name

The name of the organization you currently work for.

Name of Facility Contact

Your name.

Please enter your work email.

NSH Zone

What Nova Scotia Health Zone does your facility/organization primarily operate in?

Number of beds (LTC/RCF)

If your facility/organization has beds please enter them here, if not please enter 0.

Number of clients serviced (Home Care / Home Supports)

If your facility/organization is a Home Care/Home Support organization please enter the number of clients you assist in your service area. Otherwise, please enter a 0.

Do you currently have any in-house GPA coaches?

of Zone deliver

Within your facility/organization do you currently deliver GPA training?

Select a training training date

Applicant(s) Details

Please enter the details for requested for each applicant you wish to train.

Applicant Name

Applicant Email

Please enter the applicants personal email, not their work email.

Applicant Position

Please select one of the dropdown options.

Other – Please specify

If you selected “Other” to the above question, please specify the role here. Otherwise, you may skip this field