CHPC (Group) Application Form

Certified-High-Performance-Group-Coaching-sm

Information Questionnaire

The questionnaire below serves as a way to rank your starting point before beginning the Certified High-Performance Group Coaching program.

Please answer the questions below honestly and to the best of your ability. There are no right or wrong answers.

You will receive a copy of your answers for your files. I will also receive a copy.

You don't need to try to impress me or anyone else. The questionnaire gives you a way to rank yourself in a variety of high-performance habits or areas, gets you thinking about and more familiar with some of the terms we will use during your Certified High-Performance Group Coaching sessions, and helps me get to know you a little bit better.

Not responding to every question will result in unsuccessful submission of the form, and neither you nor I will receive your responses.

First Name*
Last Name*
At what email address would you like to be contacted?*
Skype User Name*
In what country do you live?*
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In what time zone are you?*
Clarity
Do you feel you are clear about who you are, your purpose and the direction you want to go in life?*
On a Scale of 1-10 (with 1 being "no, not at all" and 10 being "absolutely, yes")
Energy
Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?*
On a Scale of 1-10 (with 1 being "no, not at all" and 10 being "absolutely, yes")
Courage
Do you take action and consistently express who you truly are, and what you truly think, need and desire with the world?*
On a Scale of 1-10 (with 1 being "no, not at all" and 10 being "absolutely, yes")
Productivity
Are you consistently focused and effective, and are you good at minimising distractions and maintaining priorities?*
On a Scale of 1-10 (with 1 being "no, not at all" and 10 being "absolutely, yes")
Influence
Do you feel you have the social influence with your family, friends and team needed to accomplish your goals?*
On a Scale of 1-10 (with 1 being "no, not at all" and 10 being "absolutely, yes")
What do you do for a living, and why did you choose that career?*
What are your top 3 goals you are striving to achieve right now?*
What major stressors or challenges are you struggling with right now?*
When you feel like your most successful and happy self, what makes you feel that way?*
What would your dream life look like if you could wave a magic wand and make it happen?*
What has prevented you from having that dream life?*
What goal or dream have you ever given up on or failed at?*
What 3 big changes would you like to make in your life in the next 12 months?*
What are you most proud of and excited about in your life?*
Why would you like to work with a High Performance Coach?*
Why do you feel you could be a great student or coaching client if we worked together?*
Phone
This field is for validation purposes and should be left unchanged.

Successful submission of your form will take you to a thank you page. If you are returned to the top of this page then there is an error on your form and you will need to scroll back down and respond to the questions marked in red before resubmitting.

Information Questionnaire

Clarity

Energy

Courage

Productivity

Influence