Influencers Questionnaire

Influencers Questionnaire
This information will enable us to:
- Design programs, activities and provide examples that are applicable for your industry and level of experience and responsibility
- Present content that is targeted to specifically meet your needs
- Ensure we can connect you with others in the church community who might be able to meet your needs as well as those that you might be able to assist
- Provide resources that will empower you on your personal growth journey
Each person attending should fill out this form. If you are attending with your spouse please have them fill out this form separately.
Name*

First NameLast Name
Email*
example@example.com
Address

Street Address

Street Address Line 2

SuburbState

Postcode
Age Bracket*
Gender*

MaleFemale
Industry*
Occupation*
Role / Position*
No. of Employees in your company/organisation*
Number of staff excluding you
Number of Direct Reports*
Years of Experience in Role*
Personal Strengths that you bring to your role / position / company*

LeadershipTeam playerIndependentVisionaryStrategic thinkerSystems thinkerAnalyticalCreativeEffective Communication skillsCompetence in required skillsGrowth Mindset – Willing to learnProactivePlanning and deliveryDeliver on GoalsBeing a role modelLiving my faith authenticallyOther
Areas of Challenge for you in your role / position / company*

Working with othersEffective CommunicationTrustVulnerabilityLeadershipMeeting own expectationsMeeting other’s expectationsStrategic ThinkingSystems thinkingBiblical understanding and application of principles in the workplaceApplying faith in workplaceOther
Areas of interest that you would like addressed in the influencers program*

Doing Business God’s WayLeadershipTeam BuildingHuman Resources and RelationsCommunicationBuilding CultureStrategic PlanningManaging ChangeMarketingOther
Please add any specific information regarding the above question
EG: If you responded communication – is this about communicating vision, or interpersonal relations, or talking to your boss, or your direct reports etc…
Content Areas you would have expertise to present on*

Doing Business God’s WayLeadershipTeam BuildingHuman Resources and RelationsCommunicationBuilding CultureStrategic PlanningManaging ChangeMarketingOther
Should be Empty: