You can always press Enter⏎ to continue
APPLY HERE!
Take a few minutes to fill out this application in as much detail as possible.
13
Questions
START
1
Are you here because you are looking to lose weight, regain your confidence, and NOT have a crazy diet rule your life; ensuring this is the last program you will ever need?!
YES
NO
Previous
Next
Submit
Press
Enter
2
Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
3
Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
4
What is your name on Facebook?
Facebook handle
Previous
Next
Submit
Press
Enter
5
What makes the Keep It Off Academy such an appealing option for you?
*
This field is required.
I've seen some of the results from the hundreds of women you've helped, and I want this for myself!
I know I need to boost my metabolism and diets seem to be crashing it.
I have a busy schedule and I need support structuring a plan that fits my life.
I've been struggling on and off with this for years, and I'm ready to do something that promotes lasting change.
Previous
Next
Submit
Press
Enter
6
What have you tried in the past, and why didn't it work?
*
This field is required.
Or, if it worked temporarily, why didn't the results last?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
7
What do you think has been preventing you from keeping weight off?
*
This field is required.
CHECK ALL THAT APPLY
Lack of consistency
Metabolism and/or Hormones
Confusion about what I should be doing
Previous
Next
Submit
Press
Enter
8
What will life be like in 10 years if you do not solve this problem?
*
This field is required.
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
9
What will change in your life once you hit your goal, regain your confidence, & never have to diet again?
*
This field is required.
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
10
If you were referred to this program by a coach, friend, or a Keep It Off Brand Ambassador, please let us know who sent ya!
Previous
Next
Submit
Press
Enter
11
Do you have a significant other? If yes, are they supportive of you investing in your health, weight loss goals, and mindset growth?
*
This field is required.
Yes - I have a significant other and they are very supportive.
Yes - I have a significant other but this is my decision to make.
Yes - I have a significant other and they may need to be on the call with me to make a joint decision.
No - I'm single and I do what I want. ;-)
Previous
Next
Submit
Press
Enter
12
Right now are you ready, willing, and able to invest in your health and never have to diet again?
Yes I have the cash flow to invest in myself.
Yes, I may not have the cash flow but I'm resourceful and/or have access to credit.
No I do not have the means to invest at this time.
Previous
Next
Submit
Press
Enter
13
CHOOSE YOUR NEXT STEP
*
This field is required.
I'm pretty sure I'm ready for this - and I'd love to book a FREE 15 minute Strategy Session to speak with Nikki before committing.
I'm not ready yet but I'm getting close and looking at all of my options. I would love a FREE 15-minute Strategy Session with Nikki to learn more about how this can help me.
I'm not ready to chat or join yet, but keep my application on file because I know I'm going to do this program when the time is right!
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
13
See All
Go Back
Submit