Coaching Application

Coaching Application
Thanks for your interest in the coaching program!
Please fill out this form to let us learn more about you. You'll receive a follow-up email letting you know if the program is a good fit for what your situation.

Your privacy is important to us. No information you submit will be shared with third parties.
About You
First Name*
Last Name*
Email*
example@example.com
Your Time Zone*
You must be available between 9am and 8pm Eastern Time (UTC-5).
About Your Work
Company or Organization*
What is your current title?*
5-7 years8-10 years11-15 years16+ years
Tech leadStaff engineer - single teamStaff engineer - multiple teamsArchitectManagerDirector or Vice PresidentOther
How Can I Help?
Productivity and time managementLeadership and influenceGetting promotedCareer developmentOpen source kickstartI'm not sure
Please list three goals you have for your career. *
Think in terms of what you'd like to accomplish in the next three months, one year, and three years.
Please list three challenges you are currently facing or will face in achieving these goals.*
How do you feel that coaching will help you?*
Please be specific: what kind of help are you looking for?
Additional Information
12-call/12-week program ($3,800 USD)6-call/12-week program ($2,000 USD)One-time call ($350 USD)Other
My employer (as direct invoice)My employer (as reimbursed expense)Myself
PodcastTwitter/XMastodonLinkedInGoogle SearchHuman Who Codes websiteOther
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About You