Name *

First Name

Last Name

Phone *

Country

(###)

###

####

Prior Coaching Experience *

Have you experienced coaching before?

Yes

No

Somewhat

What services are you interested in? *

Pro Bono

The Essayist’s Path (1:1 Executive Coaching)

Burrow Sessions (Private Intensives)

The Second Curve Track (Advisory Engagements)

Availability *

Are you available for approximately 10 hours of coaching over the next 3–4 months?

Yes

No

Maybe

Consent to Record *

Are you willing to participate in sessions that may be recorded (audio only) for faculty review?

Yes

No

Need more info

Session Preference *

Preferred session method(s)

Google Meet

Phone

In-person

Other

Required checks *

All required to proceed

I understand this coaching engagement is confidential, except for training-related reviews.

I understand I will be asked to complete a short evaluation at the end of the engagement.

I am committed to being an active participant and to doing reflection/practice between sessions.