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Coaching Application
Family Coaching Relationship application form
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* Indicates required question
Email
*
Your email
What are you applying for? Name and package price: (if you are unsure, please check current pricing on website)
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Your answer
Full Name of all family members you expect to participate in coaching
*
Your answer
Will you be responsible for ensuring any members who join our sessions signs the agreement?
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Yes
Email/Phone
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Your answer
Location
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Your answer
Have you worked with a coach before or a similar one-on-one adult relationship? (e.g. tennis coach, piano, mentor, teacher, and therapist)?
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Your answer
If so, what worked well for you and what did not work in the relationship(s)?
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Your answer
What are your top stressors? (What causes you stress?)
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Your answer
Rate your life satisfaction out of 10. 10 being highest.
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1
2
3
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5
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10
Describe your relationship with your family to me:
Your answer
What do you require from me?
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Your answer
What do you think is missing from your life?
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Your answer
How will you know you have received your value for money?
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Your answer
What is your vision for your whanau?
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Your answer
A copy of your responses will be emailed to the address you provided.
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