Tell us a little about you and your career goals.

Name

First Name

Last Name

Phone Number

(###)

###

####

Which statement describes you best:

I'm just starting out in my career

I've held a few positions and I'm starting to find my groove

I'm a long-timer in the tech world

What's your current job title and salary?

What do you love about being in technology?

What are your career goals? (Think 1 year, 5 years, 10 years out and include job titles, what you want to be doing, and target salary.)

Briefly tell us what your biggest challenges or roadblocks are in achieving these goals.

We will call you at the time you chose, and we want to make sure you are excited about your appointment time and committed to having an engaged conversation with us. Please type the following in the box below to indicate this: “Yes, I promise I will answer the phone when my coach calls, and I’m excited for the conversation.”

On a scale of 1 to Gerri Martin-Flickinger, how awesome are you at your job? Why are you THE ONE to break through the barriers and have your goals?

 <a href="https://raikatech.wufoo.com/forms/z1u1uysg0kal3nj/">Fill out my Wufoo form!</a> 

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