EmailMeForm
Executive Accelerator Forensic Science
Please complete this form to register as a participant in the Executive Accelerator program. You may opt to save your answers and complete the form within 10 days. Please see the Save and Resume link at the bottom of this page.
I understand that my information will be kept confidential:
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Yes
Participant Name:
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First
Last
Participant Nickname:
If other than your first name, how would you like to be addressed?
Employer:
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By what organization are you currently employed:
Years at current employer:
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Years in Forensic Science:
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Years of formal management experience:
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Position/Job Title:
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Please list your current work capacity
Participant Email:
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Confirm Email:
Mobile Phone:
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Work Phone:
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Laboratory Mailing Address:
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Marital Status:
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Please select
Never Married
Engaged
Married
Separated
Divorced
Widow/Widower
Number of Children:
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Please select
0
1
2
3
4
5
More than 5
Which of the following best describes you, right now?
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Emerging Manager/Leader
Developing Manager/Leader
Experienced Manager/Leader
Executive Manager/Leader
Which of the following describe why you might benefit from participating in the Executive Accelerator program?
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I have specific goals I want to accomplish
I have specific problems I want to solve
I want to learn and gain insights that improve my executive leadership abilities
None of the above
As part of this program, you will work with a trained executive coach who has extensive forensic science experience. What do you most hope to gain from working with your coach?
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To improve my personal effectiveness and well-being
To improve my professional effectiveness and well-being
To create opportunities for career advancement
To develop my leadership & managerial skills
To prepare myself for increased responsibilities
To work with a "thought partner" in whom I can confide
To identify and correct bad habits
To get support and advice or a challenging situation
To seek assistance in dealing with other personal challenges
Other not listed here
I'm not really sure
What level of stress or pressure do you experience on a regular basis in your PERSONAL life?
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Please select
Unusually high
High
High at times
Average
Low
What level of stress or pressure do you experience on a regular basis in your PROFESSIONAL life?
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Please select
Unusually high
High
High at times
Average
Low
Do you care for an elderly person or someone with a serious illness or disability?
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Please select
Yes
No
In the last 12 months, have you had any disciplinary action taken against you by your employer?
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Please select
Yes
No
How often do you cope with feelings of frustration, anger, disappointment, or other negative feelings about your career or your current employer?
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Please select
All the time
Frequently
Sometimes
Every now and then
Not much
Never
Have you suffered any major loss or tragedy in the last two years?
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Please select
Yes
No
Personal Narratives
Please take just a few minutes to answer the following questions to help your coach learn more about you. You have a maximum of 100 words per answer. The information you provide significantly boosts the quality of your coaching sessions and will help your coach guide you toward your personal and professional goals.
How things are currently going for you in your career - what is going well and what do you wish was going a bit better?
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What do you feel are your greatest attributes or personal characteristics?
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If you could change or improve anything about yourself, what would it be?
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Describe any serious personal or professional hardships that you are coping with right now:
What are your hopes and goals for the next five years?
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Please share anything else you would like to tell us about yourself or your goals:
Client Acknowledgements
Please carefully read the following acknowledgements and click yes to indicate your agreement
I understand that suggestions or advice provided to me by my coach(s) does not compel me to act in any way. Any actions I take or decisions I make are based soley on my own judgement or discretion:
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Yes
I understand that coaching is not a form of therapy or medical treatment:
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Yes
I understand that the value of coaching depends, in part, on my honesty, thoughtfulness, and the effort I put forth to work in partnership with my coach:
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Yes
I agree to tell my coach if I ever feel like the coaching sessions are not helping me:
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Yes