Board Portfolio® Blueprint – Client Intake Form - Kylie Hammond - Executive Search & Coaching Group

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Board Portfolio® Blueprint – Client Intake Form

Board Portfolio® Blueprint – Client Intake Form

Personal Details

First Name

Last Name

Email

Phone/Mobile

Location (City / Country)

Professional Profiles

LinkedIn Profile URL

LinkedIn Social Selling Index (SSI) Score

Website or Professional Portfolio (optional)

Document Uploads

Board Resume

Choose File

Executive Resume / CV

Choose File

Corporate Biography

Choose File

Media features or articles

Choose File

Governance certificates or training transcripts

Choose File

Any other relevant documents

Choose File

Board Experience

Have you previously served on any boards or advisory committees?

Yes

No

If yes: organisation name, your role/title, dates of service, key achievements

Board Role Interests

Types of board roles you are interested in:

Not for Profit

Advisory Board

Private Company

Government or Statutory Authority

ASX Listed / Corporate Board

Other (please specify)

Industry Alignment

What industries or sectors are you most aligned to?

Governance Training

Have you completed any governance or board director training?

Yes

No

If yes: course name, institution, and completion year

Challenges and Opportunities

What challenges or barriers are you facing in securing board roles?

What strengths or unique value do you bring to a board?

Have you had any recent traction with applications, networks, or approaches?

Career Background

Brief overview of your career background

Top three career achievements or leadership contributions

Board Career Goals

Your board career goals for the next 6–12 months

What outcomes you want from the Board Portfolio® Blueprint Assessment

Additional Information

Anything else we should know (career considerations, leadership challenges, branding issues, transitions, industry context)

Agreement

Checkbox Field

I confirm the information is true and accurate.

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Kylie's Contact Details

1300 669 139
02 9487 2211

info@kyliehammond.com.au

Level 19, 10 Eagle Street
Brisbane QLD 4000

PO Box 1129
Sanctuary Cove QLD 4212

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