Franklin University Career Coaching Program

This form provides the coach with information that will enhance the coaching relationship. Please provide the following information to help identify and achieve your coaching goals.

Coaching Application

Contact Information

Full Name
City		State
Phone
Email

Are you a current student or alumni?

Where are you on your career path?

Are you currently employed?

Name of Employer

Position/Title

Duration

Duties

In 3-4 sentences, please summarize your prior work and educational experiences.

What degree(s) and/or certification(s) do you have and/or are currently pursuing?

Degree/Certification	College/University	Major	Year Obtained

What are the primary reasons you want to enter into a coaching relationship at this time?

How would you rank your current level of satisfaction with your current/most recent job?

What was your greatest success this past year?

Choose an area or areas you’d like to focus on in your coaching:

Skills, interests and values identification
Career planning
Job market information and feedback
Interviewing
Relationship building/networking
Communication
Work, life and school balance
Other - Please state:

What is your biggest challenge right now? Or, to put it another way, what factors are holding you back from having everything you want in your professional career?

What are your most important goals for the next six months?

1)
2)
3)

How did you hear about the Career Coaching Program?

Please specify how you heard:

Note: Coaching relationships are confidential. Unless you disclose issues that your coach is required to disclose to the authorities (e.g., intent to harm yourself or others), all of the content of your conversations will be held in confidence.

I have read and agree to the above confidentiality statement.