PCC Session 3 Guest Client Questionnaire

Please provide the following details to help us match you with the most appropriate coach for your session. All information is for matching purposes only and will not be shared with anyone (including your coach). Thank you!

Event for which you are registering*
Please choose the date you’re signing up for, paying close attention to the time zone.
Name*
Email*
Phone number (in case we need to reach you on the day of the event)*
Age*
Occupation*
What are you hoping to discuss with your coach? (2-3 sentences)*
This can be anything at all: a habit you’d like to change, work issues, relationship conflict, or anything else. If your topic changes between now and the event, that is fine. This is just to give us an idea of who you are and what is going on in your life.
In what way(s) have you already tried to address the issue?*
Do you know someone in the class? If so, please let us know their name so we don't match you with them for this event.
How did you learn about this opportunity?*
Are you considering pursuing training as a coach?*
- Yes
- No
- I Don’t Know
Are you interested in personal development courses with New Ventures West?*
- Yes
- No
- I Don’t Know
Event Details & Agreement*
By checking this box you acknowledge and agree to the following:
This is a live event where you are matched in advance with a coach. As a condition of your registration you are expected to be available from 9:45am – 4pm on the day of your event (with a break for lunch)
Today's Date*
MM slash DD slash YYYY