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Events
View upcoming Introduction to Conscious Leadership events
2024
Other location name:
1:1 Coaching Interest
Watch this
video
to learn about the difference between conscious leadership coaching versus other forms of coaching.
Our coaching is virtual via video.
Personal Info
Name:
Email address:
Phone number:
LinkedIn Profile or Personal Website
What is your Enneagram Type (if known)?:
Select your age range
Select one...
20 -25
25 - 35
35 - 45
45+
Organization Info
Company Name
Your Title
Are you a Leader within your organization?
Yes
No
How many people work in the entire organization?
Do you have direct reports? If so, how many?
Leave blank if none.
Coaching Info
What is your reason for wanting coaching?
What 1 - 3 qualities are you looking for in a coach?
Which coaches are you currently interested in on our team?
Which coaches are you currently interested in on our team? Information on coaches is available
here
.
Please indicate first, second, and third preference.
First Preference
Select one...
Jim Dethmer
Joyce Chen
Jim Fallon
Kate Hutson
Sierra Larson
Michael Norton
Dolores Stevens
Second Preference
Select one...
Jim Dethmer
Joyce Chen
Jim Fallon
Kate Hutson
Sierra Larson
Michael Norton
Dolores Stevens
Third Preference
Select one...
Jim Dethmer
Joyce Chen
Jim Fallon
Kate Hutson
Sierra Larson
Michael Norton
Dolores Stevens
Who will be paying for your coaching?
My company is paying for my coaching
I’m paying for coaching myself
Confirm that my company is paying for my coaching
Company Address (for billing purposes)
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Ohio
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Oregon
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Tennessee
Texas
Utah
Vermont
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Washington
West Virginia
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Wyoming
Company's Annual Coaching Budget
Confirm that I am paying for my coaching
Personal Address (for billing purposes)
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
How did you hear about The Conscious Leadership Group?
Select one...
LinkedIn
Web Search
Instagram
Google
Podcast
Introduction to Conscious Leadership
Book "15 Commitments of Conscious Leadership"
Recommended
Going Deeper Newsletter by Jim Dethmer
CLG Newsletter - Coach Article
Have you already booked a Next Steps Meeting with one of our coaches? If yes, please specify which coach you're meeting with.
Select one...
No
Yes - Joyce Chen
Yes - Sierra Larson
Yes - Kate Hutson
Yes - Jim Fallon
Yes - Michael Norton
Yes - Dolores Stevens
Sign up for the Conscious Leadership Newsletter
Sign up for the Conscious Leadership Welcome Series
Sign up to be notified of our upcoming events and offerings
Thank you for completing our inquiry form! Someone will be in touch with you within the next 1-3 business days.
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Coaches
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Integrity Boot Camp Registration
Don't see a date you can attend? Join the waitlist for future events.
Circle Registration
Forum Registration
Personal Information
Forum location:
Select one...
Chicago
San Francisco
Boulder/Denver
2024
Other location name:
Name:
Email address:
Phone number:
What is your Enneagram Type (if known)?:
Organization Information
Name of Head of Organization if not you
Is the head of the organization familiar with The 15 Commitments and interested in role-modeling-conscious leadership?
Select one...
Yes
No
Not sure...
Do you have direct reports? If so, how many? Leave blank if none.
How many people work at your organization?
Forum Information
Why is being a conscious leader important to you?
What is your experience with personal development and self-awareness?
Have you read The 15 Commitments of Conscious Leadership?
Yes
No
Have you attended a Taste or an Intro?
Yes
No
(If you answer
No
, we recommend doing a Taste prior to attending a Forum.
Register for a Taste here
)
Why are you interested in joining a CLG Forum?
Tell us in two sentences why you will be a net positive impact to a forum of peers; what is the special gift you bring?
Are you in an intimate relationship? If so, how does your partner or do your partners feel about you doing this forum? Are they interested in doing their own inner work as you participate in this forum?
Are you willing to reveal all significant secrets and withholds to any relevant parties by the end of this forum?
Yes
No
Registration Agreements
I agree to:
Take 100% responsibility for my physical, emotional, mental and spiritual well being throughout the Forum.
Stay curious in the face of all challenging feedback, including looking at the opposite of all of my stories.
Be deeply curious and willing to question all of my beliefs.
Commit to giving direct feedback with my peers and facilitators.
Attend all 10 sessions.
Attend all in person retreats.
Show up for a 30-minute learning partner practice once a week.
Spend a minimum of 15 minutes per week to respond to the weekly prompts on Slack.
Have a 10 minute daily meditation practice.
Participate for the entire session, including arriving on time and staying until the end.
Mental Wellbeing Agreement
Should deeper psychological triggers get activated, I agree to take responsibility for getting outside support from a medical or psychological professional. I understand that this is not a therapy forum.
To best support you, please provide the following
confidential
information:
Are you currently under the care of a psychiatrist or psychologist?
Yes
No
Are you currently taking any medications for emotional/mental challenges?
Yes
No
Have you ever been hospitalized for psychiatric care or any mental/emotional disorder?
Yes
No
Have you ever had a "nervous breakdown" or been diagnosed with any of the following: bipolar, schizophrenia, obsessive compulsive, borderline, PTSD, or psychotic disorder?
Yes
No
Have you ever attempted suicide?
Yes
No
If yes was selected on any above
, are you willing to have your doctor write a written statement okaying you for this forum?
Yes
No
Who will be paying for this Forum?
My company is paying for my Forum
I’m paying for my Forum
Confirm that my company is paying for my Forum
Company Address (for billing purposes)
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
Confirm that I am paying for my Forum
Personal Address (for billing purposes)
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
Is there anything else you would like us to know?
Thank you! Your submission has been received!
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Team Training Interest
Personal Information
Name:
Email address:
Phone number:
Your LinkedIn Profile or Personal Website
What is your Enneagram Type (if known)?:
Organization Information
Company Name
Your Title
Name of Head of Organization if not you
Is the head of the organization familiar with The 15 Commitments and interested in role-modeling-conscious leadership?
Select one...
Yes
No
Not sure...
Your company's ideal budget
Company Address (for billing purposes)
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
Is this a Virtual or In-person event?
Select one...
Virtual
In-person
Length of time for Facilitation
Is there anything else you want us to know about your event?
What Would you Like Training To Be Focused On?
Select one...
Intro to Conscious Leadership for my Team
Zone of Genius
Candor
Appreciation
100% Responsibility
Impeccable Agreements
How did you hear about the Conscious Leadership Group?
Select one...
LinkedIn
Instagram
Google
Podcast
Recommended
Going Deeper Newsletter by Jim Dethmer
CLG Newsletter - Coach Article
Have you already booked a Next Steps Meeting with one of our coaches? If yes, please specify which coach you're meeting with.
Select one...
No
Yes - Joyce Chen
Yes - Sierra Larson
Yes - Kate Hutson
Yes - Jim Fallon
Yes - Michael Norton
Yes - Dolores Stevens
Sign up for the Conscious Leadership Newsletter
Sign up for the Conscious Leadership Welcome Series
Sign up to be notified of our upcoming events and offerings
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
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