IEECE | Life Skills Coaching - Center/Group Intake Form

Center Name*

Center Address*

Director Name*

Email*

Phone*

What do you hope your center will gain from our coaching sessions? Example: “My team wants to learn better time management skills" or "We want a coach to come to our center and teach us breathing techniques to use when we are stressed."*

Please list 3 topics you would be interested in for group sessions: (example: professionalism, meditation, planning and setting goals)*

Would you prefer a online or in-person group session? In-person may be done in-center or on a PBSC campus location (Lake Worth, Palm Beach Gardens, Loxahatchee, Boca Raton)

In Person

Online

Please list your preferred days and times for group sessions:*