Gender:

Address:

Email address:

Present role/position:

(E.g. 3rd year Law student at University of the North )

Any special accommodation required (indicate as applicable):

General summary of background (briefly complete what is applicable to you):

Personal (family, relationships and general things about your personality etc.):

Studies (present and aspirations):

Work experience:

Significant events in your life that impacted you:

Your strengths and weaknesses:

COACHING REQUIREMENTS:

2. Are you able to commit to being available for the scheduled session/s

3. Indicate specific days and times that work best for you

FOR INDIVIDUAL COACHING NEEDS: (Complete only if applicable)

2. Are you voluntarily electing to use coaching as your developmental resource or have you been advised/ instructed to enter a coaching intervention? Explain

3. Is there any specific background information that needs to be considered regarding your coaching requirements?

5. If yes, explain:

Interventions used:

Time spent on intervention/s:

Result attained:

Feedback on the experience:

FOR GROUP COACHING NEEDS: SELF DEVELOPMENT/PERSONAL MASTERY (Complete only If applicable)

2. Are you comfortable joining an online learning group of people with similar requirements?

3. Are you part of a group requiring development? If so provide following details:

Group size:

Group background: (general relating to personal common point)

When would the group like to begin programme: (date and time options):

• If yes, explain:

Interventions used:

Time spent on intervention:

Result attained:

Feedback on the experience:

FOR GROUP COACHING NEEDS: ORGANISATION (Complete only If applicable)

2. Group size and job title/expertise

Group size :

List group members and positions

4. If yes, explain:

Interventions used:

Time spent on intervention:

Result attained:

Feedback on the experience:

PAYMENT METHOD:

1. Do you have a sponsor who will be paying for your coaching? Y/N Please provide details

2. Are you paying for the session/s yourself?

3. Are you selecting to complete goal session series and/ or individual coaching sessions/or still need to decide based on discussion in first coaching session? (INDIVIDUAL)

4. For Group sessions are you paying for the group or is it individual payment options available

Please be aware that payment sessions to be paid for upfront to confirm booking

BIOGRAPHICAL INFORMATION: