Coaching Program - COACHEE Registration Form
For the COACHEE (those looking to receive coaching): Please fill out the form below.

For the COACH (those looking to provide coaching): Please email
Email address *
Part 1: Contact & Demographic Information
What is Your First Name? *
What is Your Last Name? *
Cell Phone *
In case we need to get immediate hold of you during the program.
Zip Code *
Race/Ethnicity *
Gender *
Birth Year *
Work/Profession/Industry *
You can add more details about your work/profession below, so please be brief here.
Part 2: Coaching Preferences
What type of coaching are you looking for? *
Please select all that apply. For a description of each topic, please visit our Coaching website at
Are there specific skill sets, life experiences, or other qualities you'd like in your coach? *
What method of communication do you prefer? *
This helps us coordinate coach/coachee meetings and schedules.
No preference
Face-to-face meetings
Video conference calls (skype, google hangouts, etc.)
Phone meetings
Identifying Your "Felt Needs"
All coachees must identify 1 or 2 "felt needs" prior to working with a coach. A coachee's "felt needs" will be the main area of focus that coaches and coachees will work on during their time together.

Definition of a "Felt Need": "a need, issue, problem, or question one seeks to change, correct, or otherwise grow in, in order to better their lives (especially in the professional realm)."

Examples of "Felt Needs":
• I want to become a better leader in my congregation.
• I want my business to make more money.
• I want to get promoted or otherwise move up the ladder in my organization.
• I want to better discern God's vocational call in my life.

******PLEASE NOTE!****** The more detailed you are in the next few questions, the better we can match you with the perfect coach!
Please describe the 1 or 2 FELT NEEDS you'd like to work on with a coach. *
Please write a short biography of yourself. *
You can include information about your educational and church background, work history, extra-curricular and volunteer activities, and career/calling/future goals and ambitions.
Part 3: Everything Else
The De Pree Center has scholarships available to those who need it. Please indicate below if you need a scholarship. *
Remember, our Coaching Program is $300.00 for 4 sessions ($75/session).
How did you hear about the De Pree Center's Coaching Program? *
Please select all that apply.
Part 4: What Happens Next?
Thanks for filling out the form! Here's what happens now:

1. The De Pree Center will use your information to select a coach to pair you with.

2. We will inform both you and the coach of the selection. You both must agree to the pairing. (Should either of you not want to move forward, a new coach will be selected for you.)

3. Once both you and your coach agree to the pairing, you will conduct a preliminary phone call to discuss your 1-2 felt needs and set some clear goals before your first coaching session. This phone call will also plan out logistics (time, dates, payment, etc.) as well as how to best structure and format the 4-coaching sessions.

4. Once the preliminary phone call is conducted, you and your coach can begin meeting.
A copy of your responses will be emailed to the address you provided.
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