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ioc Daoland Application Form
Please be as complete as possible so that we are both well prepared when we talk. Let's both get as much out of this to see if the program is what you need and want!
10
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1
Take Photo
This way I know who I am talking to,
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2
Full Name
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3
Mobile Phone Number
Area Code
Phone Number
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4
Email
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5
What's Your Primary Goal?
Your choice is not a permanent choice, in our conversation you come to learn about what you need and want.
learn about health cultivation
learn about daoism, buddhism and confucianism
understand acupuncture
understand massage
feel balanced and involved in my community
become a taiji gongfu master and able to practice neidan meditation
Feel amazing and in control over what i can do while working
build a career in natural and holist fitness and health
I am interested in Wudang daoism and health
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6
Describe your dream outcome, regarding your health, fitness and career
What do you think the Daoland fasttrack program can help you with in the above fields?
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7
Honestly, why didn't you sign up earlyer?
What aspects of your personality, health or life environment are holding you back to fulfill your expectations and needs?
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8
On a scale of 1-10, how serious are you about changing your life, forever?
You might be busy with improving your life for some time, but understanding the need to change is a great help in actuall change.
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9
This is not a question
There is no need to fill anything here. This widget is to warn me when your submission is made so i can react asap
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10
Let us have a Chat
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This field is required.
I need your consent to call you or email you to talk about your choices. I Aim to contact you persoanlly within the shortest time possible when you send in the form. If you concent below with a yes, also please ad what medium you like me to contact you,
Yes contact me
telephone
whatsapp
email
sms
wechat
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11
Date
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Date
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