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STEP 3
NEW MEMBER FORM

NEW MEMBER FORM

Please fill out this form carefully. It helps us prepare for our initial coaching session.

What is your job status?
I have an employer
Retired
Between jobs
Student
Self-employed
Work Schedule
Mon - Fri (standard work hours)
I set my own hours
Work days and hours vary
Not working right now
Other
How many hours do you work per week?
Less than 20
Between 20 and 40
Between 40 and 60
More than 60
N/A
Which best describes your work day?
Unpredictable (each day is different)
Extremely busy (constant demands)
Laid back (a lot of downtime)
Very routine (stick to a set schedule)
Other
N/A
What does your work day entail? (Select ALL that apply.)
My meetings occur based on when I schedule them
never
less than 20% of the time
between 20 and 50% of the time
more than 50% of the time
N/A
For my job I am required to manage
myself only
1 to 4 people
5 to 20 people
between 20 and 50 people
more than 50 people
N/A
I probably am most effective with undesirable tasks requiring high focus during the
morning
afternoon
evening
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