Coaching Request

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FOR MEMBER USE ONLY

Please complete this form to schedule your coaching session as part of your membership benefits. If you are not a member, visit our Membership page to join.

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Coaching sessions may be conducted in person or using our video conference platform.
New Cancellation Policy*
If it is necessary to reschedule, we require that you let us know at least 48 hours in advance in order to be respectful of our coaches time and preparation. Sessions missed or canceled with less than 48 hour notice will be forfeited and any fees collected will be nonrefundable.
- I have read the cancellation policy
First and Last name*
Street Address*
City, State, Zipcode*
Email*
Website
Cell Phone*
Organization*
How are you associated with us?*
Are you requesting a one-hour coaching session, or a thirty-minute free consultation (to determine what coaching topic is best)?*
Follow these instructions to schedule your appointment then enter the date/time of your phone appointment in the box below:*
Open a new browser to cut and paste the link below in order to schedule your consultation. Choose one of the available dates/times and you will be emailed a confirmation. Then return to this form to complete and submit: https://calendly.com/schedulemyappointment/30min?month=2019-11
Choose your topic here.*
Note that Level 1 coaching sessions are free (2 per year) and Level 2 sessions are $75. If you choose "other" from the dropdown list, Level 2 coaching fees will apply.
If you chose "other" from the list above, please describe your requested topic and we will confirm if we have a coach for that topic.*
If this is a follow-up session, please share the reason you are requesting this session again.
Choose your coaching level*
- Free Level 1
- $85 Level 2 or Additional Level 1
A $85 fee will be deducted from your Alliance Partner account*
- I give my permission to deduct this fee from my AP account
Coaching Fee*
Price:
Coach preference*
If you have a coach preference we will try to accommodate you but most topics require a particular coach with expertise in that area.
Date/Time Preferences: provide 3 dates/times below when you are available for this coaching session. You will be notified when the date is confirmed.
First date preference (must be at least 7 days out)*
MM slash DD slash YYYY
Time(s) you are available on the first date*
Second date preference (must be after first date)*
MM slash DD slash YYYY
Time(s) you are available on the second date*
Third date preference (must be after the first date)*
MM slash DD slash YYYY
Time(s) you are available on the third date*
Additional notes:
Total
$0.00

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FOR MEMBER USE ONLY

Please complete this form to schedule your coaching session as part of your membership benefits. If you are not a member, visit our Membership page to join.

Coaching sessions may be conducted in person or using our video conference platform.

Date/Time Preferences: provide 3 dates/times below when you are available for this coaching session. You will be notified when the date is confirmed.

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