Application for Coaching by DramatisPersonae.org
(Please note that you must be a Member in Exploriem.org before applying for DramatisPersonae.org coaching. If you have not already done so, please go to www.exploriem.org and fill in an Application for Membership. Then return here and fill in the details below and click on the "Apply" button.)

Contact Info

Dr Mr Ms

Name

Title

Company

Street Address

City

State/Province

ZIP Code/Postal Code

Telephone
-
Fax
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Email Address

Applying For

Enterprise Coaching Startup Coaching Personal Coaching Student Coaching Pro Bono Coaching Other, please specify

Other Info


Please visit http://www.dramatispersonae.org/PixieDustDefinition.htm, learn what pixie dust is and what others have done to create pixie dust in their business models and complete the 'Pixie Dust' survey. Your pixie dust describes the key value that you believe you are creating in your business or organization or it may relate to your personal skill set if you are looking for personal coaching.

Please list your three greatest strengths.

# 1

# 2

# 3

Please list your three greatest weaknesses.

# 1

# 2

# 3

Please list the areas you are most interested in improving.

# 1

# 2

# 3

Lastly, describe in a few sentences, your business or organization or personal goals:



Credit Card Information

VISA MasterCard Amex

Card #

Expiry

Name on Card

Please note that if your application for coaching is not accepted, your credit card will not be debited and all information will be deleted.

I have read the Coaching Agreement and I agree to its terms and conditions and to the charges for these services applied to the credit card I have provided above. I understand that either party may cancel this Agreement upon 30 days notice to the other party.

Thank You!


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