Intake Coaching Form

Answering these questions will help us create goals and lesson plans tailor made to address your unique circumstances.
Upon submitting this form, a copy of it will be sent to you and your coach, Jennifer Kumar.

Basic Details:

Full Name: Address:
City: State:
Pincode (Zip): Country:
Phone Number:
Corporate clients can put their business
contact information.
Employer: Job Title:
How did you hear about
Authentic Journeys?
What was the main reason
to contact Jennifer?
What is your mother tongue? What are all of the languages
that you speak?
Listening Skills - Phonetics and Accent:
You can follow/understand native American English speakers:
Additional Comments:
How do you learn and practice your American English skills?
Check all that apply.
At Work
American TV Programs
American Freinds
Speaking Skills - Phonetics and Accent:
You want help to improve your confidence talking to Americans:
Check all that apply.
In Person
Over the Phone (Voice Only)
Webinar/Video Phone
There are specific words/phrases you know that you need help to pronounce better:
When speaking to native American English speakers,
are you often asked to:
Additional Comments:
Reading & Writing Skills:
You understand what Americans communicate in their e-mails:
What prevents understanding?
How are you exposed to American English in printed form:
(Check all that apply)
American Websites
American Magazines
American Books
You are able to write e-mails to Americans that elicit understandable responses:
Additional Comments:
Cultural Aspects of American English
Rate the following questions understanding on a scale of 1 to 10 with 10 being perfect understanding.

How well do you understand the formalities and pleasantries required
in a phone conversation, voice mail or e-mail?
Additional Comments:

In attending meetings with Americans, do you understand meeting
etiquettes and the importance of speaking up and sharing your individual
Additional Comments:

Which other cultural aspects you
would like to learn to promote better communication?
Americans prefer being specific over being vague. Rate your ability to deliver specifics in a clear, concise way?
Additional Comments:

Leaving a voice mail (phone messages) is imperative to many business relationships in the US; not leaving messages in some cases could destroy business relationships. How confident are you in leaving voice mails?
Additional Comments:

Which area of the U.S. do your clients/colleagues live in?
Which techniques would you like to learn:
Check all that apply.
Slow down your speed of speech Paraphrase/Rephrase for clarity
Speak more clearly Improve vocabulary
Speak with more volume (not shout) Improve articulation/clarity of speech
Stop mumbling, decrease nervousness Prepare for presentations
Speak up and take initiative Deliver Presentations/Public Speeches
Enunciate American English sounds Write better e-mails
Understand when Americans talk fast American English spelling
Improve your confidence Online text chatting
Based on everything listed above, what are
the top three areas you would like to work on?
Agreement and Confirmation
By filling out this form and submitting it digitally, it acts as an agreement between you and Jennifer Kumar in that we will work together to the best of our abilities to achieve your goals! Thank you! I am eager to walk with you on your life's Authentic Journey!

This form is being submitted by:
(Name, as provided in Basic Details)
On the date of:

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