Program Application

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Instagram Handle or Phone Number* This field is required.

4

Age* This field is required.

5

Your Occupation* This field is required.

6

Give me a detailed description of your health and fitness goals* This field is required.

7

Please explain your current training routine if any* This field is required.

8

Please explain your current nutrition/dietary protocol if any* This field is required.

9

What's been the biggest challenge from achieving your goals? (i.e. training, nutrition, accountability, etc.)* This field is required.

10

Can you commit to training in a gym (or home gym) 3 or 4 days per week?* This field is required.

Absolutely, I can be in the gym (or home gym) 3-4 days a week

No, I cannot be in the gym 3-4 days a week or I do not have access to a gym

11

The demand to work with me is high. If you believe we are a good fit, are you ready to start right away?* This field is required.

Absolutely, I'm ready to start ASAP

Not anytime in the near future

12

I only take clients who are serious and willing to financially invest in their health and fitness. Are you willing to invest in yourself if you feel we are a good fit?* This field is required.

Absolutely, I have adequate financial resources and am willing to invest whatever it takes, my health and fitness is a top priority!

Maybe, I have adequate financial resources and am willing to financially invest, but I'd like to discuss details.

I am currently limited in financial resources and cannot afford much at this time.

I am currently unable to finanacially incest any resources towards my health and fitness

13

How did you hear about my program? If referral, please type out their first and last name* This field is required.