Immersion84 2.0 Application

I84 2.0 Application

**After submitting your application, you will be redirected to our scheduling app, to set up your discovery call**
Full Name *

First Name Last Name
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Gender *

Male Female Other
Date of birth *

Month Day Year
Social Media Contact

Please fill in any the apply to you (so we can stalk you)
Instagram@ or Facebook Profile link*
Physical
1.) What are your current physical/health goals? *
2.) Do you feel you are achieving your physical goal/goals? *

YOU KNOW IT! (yes) Fat chance (no) Somewhere in between
3.) If yes, congrats, what do you attribute that to? If not, why? *
4a.) Do you currently follow a workout regimen? *

Yes No I dabble once in a while
4b.) If so, how often?
4c.) If so, what is/are your main focus/focuses?

Aesthetics Strength Athleticism CrossFit Yoga/Pilates Cardiovascular Health Overall general health
5.) My knowledge level of health and fitness is...?(resistance training/nutrition/anatomy/etc.) *
6.) If you HAD to call yourself out on ONE thing concerning your health, what would it be? *
BUSINESS/ FINANCES
7.) What do you currently do for income? *

I work for the man/woman (I am an employee) I am the man/woman (I am a business owner)
8.) What is your title/position? *
9.) Which best describes your feelings about your current financial situation? *
10.) What are your big picture, business/financial goals? *
11.) Do you feel you are on the right path, to achieving the goal/goals listed above? *

I feel like an astronaut in the ocean (No) I am confident in my skills, but not sure how to best utilize them I could knock it out of the park with some guidance HOLD MY BEER, I GOT THIS (yes)
12.) If you HAD to call yourself out on ONE thing concerning your business/finances, what would it be? *
RELATIONSHIPS
13.) What is your current relationship status? *

Single Dating Married Divorced It's complicated
14.) Are you happy with your current relationship situation? *

Yes No They're sitting next to me, so I'll answer this later
15.) If you could change anything, about your current relationship situation-ship, what would it be? *
16.) What is your best quality as a partner? *
17.) What is your biggest drawback as a partner? *
18.) What seems to be your most common pattern in your current/past relationships? (ie. cheating/supressing emotion/dishonesty/etc.) *
19.) How are your relationships with family? (oh $#!%, didn't think we were going this deep right?!) *

I'm a lone wolf Non-existent Neutral I get along with most of them MY F%CKING TRIBE! (amazing)
20.) If you HAD to call yourself out on ONE thing in your relationships with significant others, what would it be? *
21.) What made you want to apply for this experience? *
22.) If someone you know referred you to applying, please let us know their first and last name.

First Name Last Name
Once you submit this application you will be directed to our calendar, to schedule our call!

No sweat, there's ZERO obligation at this point🤘🏽
Should be Empty:

I84 2.0 Application

Social Media Contact

Physical

BUSINESS/ FINANCES

RELATIONSHIPS

Once you submit this application you will be directed to our calendar, to schedule our call!