Agape Lens Consulting and Therapy - Agapé Lens Group Leadership Coaching Intake Form

Group Leadership Coaching Intake Form

Please fill out the questions below to help us learn more about how we can best support you.

First Name

Last Name

Email Address

Phone Number

Organization name and website link (if applicable)

Please describe the concerns that have brought you to invest in our group leadership coaching program?

What are the top three goals you would like to focus on throughout our time together?

What are your expectations or deliverables at the end of our time together?

If you are looking to address anti- racism or anti-black racism specifically, please describe how the leadership coaching sessions might support your overall anti-racism or anti-black racism efforts within your organization?*

Virtual

In person

What is the desired date of event?*

How many participants will be in attendance?

What is your budget?*

Is there any additional information we should know?

How did you hear about us?*

Social Media

Website

Google

Referral

Group Leadership Coaching Intake Form

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