The Revenge Body Application

1

What's your name?* This field is required.

First Name

Last Name

2

What's your email* This field is required.

example@example.com

3

Where are you located?* This field is required.(Country is fine)

4

Your PERSONAL Facebook Profile OR Instagram Handle:* This field is required.(I will personally reach out to you if you qualify)

5

What's your age?* This field is required.(Must be 25 or older)

6

What's your height? (feet)* This field is required.

7

What's your current weight? (pounds)* This field is required.

8

How long have you been following Maverick Online Coaching?* This field is required.

Just now

A Couple Months

6 Months to a year

More than a year

9

What is your number one struggle right now and how has it been holding you back from achieving your goals?* This field is required.

10

What is your occupation?* This field is required.

11

On a scale of 1-10, how serious are you in making a change and achieving your fitness goals?* This field is required.

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10

12

Why do you want to work with us? Our coaching program is not a cheap "cookie-cutter" or "one size fits all" program. It's hands-on 1-to-1 coaching tailored to your specific goals and needs. Are you willing to invest in yourself and hire a coach?* This field is required.

13

If you are accepted, how soon can you get started?* This field is required.

15

Do you have any other questions or want to tell me anything else about you?