Full Name *

Name

Mobile Phone *

Phone

Email *

Company / Organization

Organization

Current Role / Title *

Title

Which one best describes you? *

Emerging Leader

Mid-level Leader

Senior Leader / Executive

Business Owner / Entrepreneur

Leadership Level

What is your biggest leadership or career challenge right now? *

Biggest Leadership Challenge

If this strategy session is successful, what is the #1 outcome you’d love to walk away with? *

Desired Session Outcome

Over the next 6–12 months, what are the top 1–2 goals you want to achieve in your leadership or career? *

6–12 Month Leadership Goals

How committed are you to taking action on your growth in the next 3–6 months? *

10/10 - I'm ready to move now

7–9 – I’m serious and exploring options

4–6 – I’m curious but not sure yet

Commitment Level

If we’re a good fit, are you open to investing in coaching or leadership development? *

Yes

Possibly, I'd like to understand options

Not at this time

Open to Investment

Preferred way to connect for your free strategy session *

Zoom

Phone

Preferred Session Method

Best days and times for your session *

Best Days and Times

How did you hear about Christopher / CDHouston Leadership Development?

Lead Source (Christopher)

Anything else you’d like me to know before our call?

Additional Notes

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