Coaching Application

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Age* This field is required.

4

Phone Number* This field is required.

Area Code

Phone Number

5

Which time zone are you in?* This field is required.

6

How can I help you?* This field is required.(Select all that apply)

weight loss

healthy lifestyle

build muscle

other

7

What is holding you back from achieving your goals? (e.g. discipline, lack of knowledge, lack of inspiration)* This field is required.

8

Why do you want to start now?* This field is required.

9

Are you inquiring about online coaching or in-person?”* This field is required.(In person coaching only available at Texas Iron Republic)

Online

In-persoon

Combination

Unsure

10

How did you find me?* This field is required.

Instagram

Friend/family

TikTok

other

11

Are you ready to pay for coaching with me, including custom workout plan, nutrition assistance, 1:1 guidance & accountability to reach your goals?* This field is required.

I am ready to commit NOT ready