Authentic Journeys-Cross Cultural Coaching Intake Forms For Educational and Career Goal Setting
Pleased you chose me to encourage you through your journey. Feel free to use these forms as a guide to coach and counsel yourself through your educational goals or career change and clarification, or send them back to me for personalized coaching. Your coach and author of these forms, Jennifer Kumar, is a certified in Life & Career Coaching and hold a Master’s Degree in Social Work. I am available to work with you via e-mail, over the phone, chat programs or in person. If you decide to coach with me, please return this document to me along with these forms: “Authentic Journeys Confidentiality Agreement” (Download link) “Consent, Roles and Responsibilities of Service” (Download link) If you want me to share anything with anyone, please also fill out the form titled “Release of Information.” (Download link) The information you provide to me on these form is confidential. If you are filling this form on the computer, you can use the TAB key to tab through and fill in the blanks. You can use your mouse to move through the form as well. The version of this form found online may not support the tab fill in method. It may not also allow you to fill in the form properly. Feel free to print it out and use it on your own and e-mail the scanned version back to me or e-mail me for the Microsoft Word version at: authenticjourneys@gmail.com
Jennifer Kumar, MSW, CC, Cultural Adjustment Coach E-mail: authenticjourneys@gmail.com Web: http://authenticjourneys.blogspot.com Authentic Journeys Intake & Welcome Packet
(July 2011)
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Authentic Journeys-Cross Cultural Coaching Intake Forms For Educational and Career Goal Setting
Name: Address: City, State, Zip:
Phone:
E-mail Address: Birthdate:
Age:
Emergency Contact: Phone:
Relationship:
*please fill out a consent form for your emergency contact Where did you hear about my services? Have you experienced coaching/ career counseling/ tutoring previously? Yes How long are you looking to contract for services? (these time frames are negotiable) 1-3 months
3-6 months
9-12 months
If so please share what about the experience was helpful or what you wish was different:
Jennifer Kumar, MSW, CC, Cultural Adjustment Coach E-mail: authenticjourneys@gmail.com Web: http://authenticjourneys.blogspot.com Authentic Journeys Intake & Welcome Packet
(July 2011)
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Authentic Journeys-Cross Cultural Coaching Intake Forms For Educational and Career Goal Setting
Form for Career Coaching – Form 1 of 1 CREATING FULFILLMENT IN YOUR WORK Our work together is tailor-made to meet your needs. Please place an X in each box that is a concern to you. (Do so by putting the mouse over it and clicking.) Please read through all the options. Educational Goals – Admission into College in USA Help with Assessing Foreign Education and Career Path in USA (From India) Problem solving and prioritizing needs for college admissions in USA Living in USA on H4/F2 visa – help with figuring out American Educational System/Career goals in USA Brainstorming best educational choices for desired career in America Coaching for soft-skills, social and academic success on American campuses Other Career Goals Update my career goals/path Change my career Update my resume Find a new job in the same field Find a new job in a different field Assessing my current skills and strengths Figuring out how to update skills/ credentials /education for the next career move Start a new business Improve/create more success with my current business or job Get a raise/promotion Help with setting and achieving career milestones/ goals. Want to figure out what’s missing from my current job to make it more satisfying Identifying volunteer work that may be useful to my career and/or personal growth Help with researching career options and long-term career plans Other Cross-Cultural Coaching – Coaching for Success in the American Job Market Update education/ experience for American job market Americanizing my resume Coaching for first job hunt in America (pending college graduates, H4 wives) Other Jennifer Kumar, MSW, CC, Cultural Adjustment Coach E-mail: authenticjourneys@gmail.com Web: http://authenticjourneys.blogspot.com Authentic Journeys Intake & Welcome Packet
(July 2011)
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Authentic Journeys-Cross Cultural Coaching Intake Forms For Educational and Career Goal Setting
Return To Work After Time Away Charting career move after break away (stay at home mom/ dad) Other Moving For Job / Education Deciding where to move for job offers or educational opportunities (study abroad) Help with planning the logistics of moving for a job or educational opportunities Help with building my reputation in a new company, different city or country Other Personal and Professional Development Help with networking Make a decision about which of the options I’m considering that I want to pursue Work on my self-confidence after a layoff or time away from work Figuring out my passions / strengths/ creative talents Define my work and personal values Identify obstacles how to overcome them. Focus on my “Life Purpose” and have a broader context for evaluating my career Other
What are the top 5 criteria from the exercise you want to start to work on? 1. 2. 3. 4. 5.
Jennifer Kumar, MSW, CC, Cultural Adjustment Coach E-mail: authenticjourneys@gmail.com Web: http://authenticjourneys.blogspot.com Authentic Journeys Intake & Welcome Packet
(July 2011)
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Authentic Journeys-Cross Cultural Coaching Intake Forms For Educational and Career Goal Setting
Do you have ideas for measurable goals you would like to work on? (For example: I want to Americanize my resume in two weeks from today?)
If you could create the results you desired in these 1 - 5 areas, what specifically would you like to achieve in the next 90 days?
What would you have to do or change to make these things happen in the next 90 days?
What kind of support do you need from others or your coach (me) to help you achieve these goals?
How long do think you will need to work with me to achieve your goals?
Based on your fees of $ /hr for (number of) sessions, your fee to complete this process is . (Filling in these two lines is optional. If you want to budget your time and money, then please fill it in. Thanks.) (Click here to learn about the fee structure.) Other comments or thoughts on this exercise?
Jennifer Kumar, MSW, CC, Cultural Adjustment Coach E-mail: authenticjourneys@gmail.com Web: http://authenticjourneys.blogspot.com Authentic Journeys Intake & Welcome Packet
(July 2011)
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Authentic Journeys-Cross Cultural Coaching Intake Forms For Educational and Career Goal Setting
Signature page Please sign this page as an agreement between you and I that we will work together to the best of our abilities to achieve your goals! Please return this form to me at our first meeting along with any pages you have filled out in this form, the “Authentic Journeys Cross-Cultural Life Coaching Release of Information” and “Authentic Journeys Confidentiality Agreement” form and any “Release of Information” forms you require. Thank you! I am eager to walk with you on your life’s Authentic Journey! If you are not giving me a hard copy, but sending it back via e-mail your typed signature will be the binding signature for our work together. Thank you.
Client’s Printed (or typed) Name
Client’s Signature
Date
Jennifer Kumar __ Coach’s Typed Name
Coach’s Signature
Date
Jennifer Kumar, MSW, CC, Cultural Adjustment Coach E-mail: authenticjourneys@gmail.com Web: http://authenticjourneys.blogspot.com Authentic Journeys Intake & Welcome Packet
(July 2011)
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