EmailMeForm
ISHI COACHING
Pease use this form to sign up for a free 45-minute coaching session at the 2019 International Symposium on Human Identification in Palm Springs, CA. Times are limited but we will do our best to accommodate you. If you are interested in learning more about professional/executive coaching, please visit www.criticalvictories.com/coaching.
I understand that all information provided in this form will be kept confidential, and that my information will not be added to any mailing lists:
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Yes, I understand
Name:
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First
Last
Nickname:
If other than your first name, how would you like to be addressed?
Years in forensic science:
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Employer:
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For what organization are you currently employed:
Years at current employer:
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Position/Job Title:
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For what organization are you currently employed:
Email:
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Confirm Email:
Primary Phone:
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Alternate Phone:
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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
What are your primary goals?
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 personel 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
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?
What are your hopes and goals for the next five years?
Please share anything else you would like to tell us about yourself or your goals:
Your Day Preference(s):
Monday September 23rd
Tuesday September 24th
Either day is fine
Please select up to 5 time blocks that you would prefer:
8:00 AM - 8:45 AM (PT)
9:00 AM - 9:45 AM (PT)
10:00 AM - 10:45 AM (PT)
11:00 AM - 11:45 AM (PT)
1:00 PM - 1:45 PM (PT)
2:00 PM - 2:45 PM (PT)
3:00 PM - 3:45 PM (PT)
6:00 PM - 6:45 PM (PT)
7:00 PM - 7:45 PM (PT)
Any times are fine
