UNLOCKED

Tell Me About You
Please fill in as much detail as you can; it will help me in the delivery of a more bespoke programme.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Please provide a brief summary of your professional life : incl current role, experience, looking for a new role/promotion etc
What specific challenges are you currently experiencing? (Choose as many as you think are relevant to you)

Struggling to be heard in meetingsLack of opportunities for progressionDifficulty asserting myselfImpostor SyndromeDifficulty in making the most of relationships (peers, leaders, mentors)Maintaining connection when remote workingOther
What do you hope to achieve by the end of this programme?
Why now?
Self Assessment

Where do you feel you're at now?

How confident do you currently feel expressing yourself or your ideas at work?

	1	2	3	4	5	6	7	8	9	10

1 is Worst, 10 is Best

How confident do you currently feel expressing yourself or your ideas outside of work?

	1	2	3	4	5	6	7	8	9	10

1 is Worst, 10 is Best

How comfortable are you with difficult conversations at work?

	1	2	3	4	5	6	7	8	9	10

1 is Worst, 10 is Best

How comfortable are you with difficult conversations outside of work?

	1	2	3	4	5	6	7	8	9	10

1 is Worst, 10 is Best

Which of the following areas do you most want to improve? (Select up to 3)

Speaking up in meetingsPersonal branding and visibilityBuilding resilienceNavigating team cultureHaving difficult conversationsCommunication skillsPresentingNetworking and relationship-building
Is there any other information that you’d like me to know or any questions you want to ask?
Commitment and Availability
Please confirm you are able to commit to: attending the weekly live 90-minute Zoom sessions, participating in the private Facebook Group and completing daily tasks (Mon-Fri, between 5-30mins at your convenience)?

YesNo
Do you have a preference for any particular time of day? (I will try and pick a time/day that accommodates the majority - please let me know if there are particular days that are completely impossible in the 'any other info' box above)

12 - 1.30pm4 - 5.30pm7 - 8.30pmOther
General Terms & Payment
I understand that by completing this form, I am booking my place for Unlocked - a 9-week Group Coaching programme with Kaye James.

I am happy to receive follow up emails and be added to the mailing list for The Keyfinder. I can unsubscribe at any time following the end of the programme.

Any information noted above is for the purposes of this programme only.

My place is only secured once payment has been made.
I understand and agree
The full cost of this Beta round of UNLOCKED is £450

If you would like to pay by instalments you will need to pay £150 to secure your place and begin the programme, followed by 2 further payments of £150 - the dates of these will be agreed and all payments need to be made prior to completing the programme.

If you would like to pay in full, I am offering a £25 discount.

Following receipt of your application you will be sent an invoice.

Your place is only confirmed once payment has been processed.
I would like to pay:

In full £4253 x Instalments £450
Should be Empty:

Tell Me About You

Self Assessment

Commitment and Availability

General Terms & Payment