Mila Harvey Fitness
Coaching Application Form
Please fill out this form then wait to be contacted
Name
*
First Name
Last Name
Date of birth
*
-
Month
-
Day
Year
Date
Describe your fitness level
Beginner
1
2
3
4
5
6
7
8
9
Elite Athlete
10
1 is Beginner, 10 is Elite Athlete
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Best time to contact
*
Morning
Afternoon
Evening
What is your primary goal?
*
Lose body fat
Tone up
Maintain current weight
How much weight would you like to lose or gain?
What is your ideal timeline for your goals? (e.g., 1 month, 2 months, 3 months, etc.)
How many days do you currently work out?
0
1-3 times per week
3-4 times per week
5-7 times per week
What obstacles are holding you back from reaching your goal?
Coaching Preference
In person training (Orlando and surrounding areas)
Online coaching only
How committed are you to getting started?
*
Not ready
1
2
3
4
5
6
7
8
9
Ready
10
1 is Not ready, 10 is Ready
How did you hear about me?
Submit
Should be Empty: