Point of Need Client’s Application Are you looking for a life coach, yet feel you cannot afford one? Welcome to the Point-of-Need (PoN) program of the Christian Coaches Network International (CCNI). The Offering We will match you with a CCNI member life coach for 10 sessions. This can be done over the phone or via video conferencing or even face-to-face if possible. The length and topic of each coaching conversation will be up to you and the coach to determine. Your only task is to show up ready to discuss an area of your life where you would like to move forward. There is a one-time $20 admin fee which can be paid during the application process (see below) or later. CCNI member coaches contribute their time because they want to see you go from stuck to unstuck. They also gain experience and coaching hours which they can use for credentialing purposes. CCNI is happy to provide this service to you because we know that there are so many people that could benefit greatly from Christian Life Coaching and do not currently have the financial means to hire a life coach themselves. The Agreement As a client, you understand and agree that you are fully responsible for your well-being during your coaching calls, including your choices and decisions. • You recognize that coaching is not psychotherapy. You understand that coaching does not attempt to treat mental disorders as defined by the American Psychiatric Association. • You understand that this coaching is not to be used in lieu of other professional services. • You understand that all decisions in these areas are exclusively your own and your actions regarding them are your own responsibility. • You promise that if you are currently under the care of a mental health professional that you will consult with this person regarding the advisability of working with a Christian life coach. • You agree that if the CCNI PoN program is not right for you, that you will be referred to a more appropriate profession who might charge for their services. If you and your Christian life coach desire to continue after the 10 free sessions, you are welcome to do so. This would then be arranged directly with the coach. CCNI will never use your information for any solicitations nor share your data with any other than the administrative team and your coach. All data will be held with the strictest confidentiality except as might be required by law. The Next Step If you agree with the above, click/tick these boxes to begin the application process: If you agree with the above, click/tick these boxes to begin the application process:* I agree with the above statements regarding Christian life coaching and the Point of Need program. I agree to have the data I share with CCNI stored electronically and shared with my life coach. I agree to pay a $20 one-time admin fee now or later. Your Name* First Last Your Gender*MaleFemalePrefer not to specifyYour Time Zone:*Eastern TimeCentral TimeMountain TimePacific TimeAlaska TimeHawaii-Aleutian TimeYour Email* Telephone #1:*Telephone #2:Preferred Mode of Coaching* Phone Video Conferencing Face-to-Face Other Other Mode of Coaching Preferred Gender of Coach* Male Female No Preference Point-of-Need coaching is centered around Life Coaching. Please rank the following from 1 (your top choice) to 9 (your least favorite with 10 being a space for other. No number should be repeated.Life/Work BalancePlease enter a number from 1 to 10.Trouble with MoneyPlease enter a number from 1 to 10.RelationshipsPlease enter a number from 1 to 10.Finding God's WillPlease enter a number from 1 to 10.Use of TimePlease enter a number from 1 to 10.WellnessPlease enter a number from 1 to 10.Discovering Who I AmPlease enter a number from 1 to 10.Emotional HealingPlease enter a number from 1 to 10.Walk with GodPlease enter a number from 1 to 10.Other (specify): To what extent do you agree with this statement: “Life coaching is best done from a biblical worldview. It is not proselytizing, nor is it recruiting for any belief-structure or way of doing things. Coaching is not therapy, mentoring, or counseling.”* Fully Agree Somewhat Agree Disagree Comments Comments: What do we need to know about you as a client?Are you prepared to pay now (or later) $20.00 a one-time administrative fee?* Yes No CAPTCHA Δ
