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Section 1
Name
Country of Residence
Select country
USA
Canada
Ireland
United Kingdom
Australia
New Zealand
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Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Italy
Latvia
Lithuania
Luxembourg
Malta
Netherlands
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
State
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Gender
Male
Female
Other
Year of birth
Select year
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
I confirm that I am aged 18 or above
Section 2
Email
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Where did you find out about this system?
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Employer/HR/Training Dept
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Other media (TV, radio, magazines...)
Other
Have you been coached before?
Yes
No
In a group setting
Section 3
Any personal strategy implemented before?
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No
Are you a qualified coach?
Yes
No
Do you work in Training, Learning & Development, or HR?
Yes
No
Is your employer reimbursing your subscription, for personal development purposes?
Yes
No
Section 4
Password
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