Coaching + Learning Program Survey Form

KAREN CINDY

Thank you for your interest in our speaking, coaching and training services.

To help us know more about your needs, please complete this questionnaire.

Trust that all the information you will share will be classified as confidential and will only be used to support the objectives of your planned programs/courses/event.

First Name

Last Name

Nickname

Mobile number

Landline / local number (if applicable)

Designation / Position

Department

Total Years of Service in the company

Company name

Years in existence

Website

Nature of business

Business address

What coaching /training/ development programs are you interested in? If you have a concept/event in mind, please share it as well.

Target date/s, duration, time and venue

Number of participants

Departments and Positions/Designations involved

Company Mission

Company Core Values

Company Vision

Reason/ Rationale/Objectives/ Purpose Behind this program?

What are your expectations, topics and issues you want to address, special requests, inputs from top management, management and participants regarding the said program?

What is the profile of the participants in terms of their areas of responsibility, tenure in the company, learning styles, attitude towards learning and development, diversity, inclusion, culture and equity?

Do you have a diversity, inclusion, and equity (DEI) initiative in your company? *

Yes

Other

What results / output would you like to see in the participants at the end of the program?

What follow up steps do you intend to take after the program to support the participants and their teams in the new skills/ learnings they will acquire? Do you have post-training/coaching follow-up activities or support? Please share.

Other important information that we need to know regarding your operations/expansion plans/regulations/ policies/ direction/ people to help us come up with a fitting program for you.