Request for a UEA Staff Coach

Data Protection note: This information will be held electronically for the purposes of matching coachees to coaches. We will not keep your personal information for longer than is necessary or use it for any other purpose. You may request your entry to be deleted at any time.

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This field is mandatory.
This field is mandatory.
This field is mandatory.
This field is mandatory.
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If you need your manager's authorisation to take part in the coaching scheme, please make sure this is agreed.

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If applicable please indicate any blocks of time when you are NOT available for meetings, eg particular weeks in the academic year or periods of every week.

This field is mandatory.
This field is mandatory.

When you have completed the form please click 'Send' to submit it to CSED.