1:1 Elite Coaching Application

1
What is your full name?* This field is required.
First Name
Last Name
2
How old are you?* This field is required.
3
What State do you live in?
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Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
4
What's your instagram?* This field is required.
5
Phone Number
Area Code
Phone Number
6
Email* This field is required.
example@example.com
7
What are some of your goals?Be specific!!
8
What has been your biggest struggle in your fitness journey and how long have you been struggling with this for? * This field is required.Be detailed!!
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9
WHY is it important for you to make these changes TODAY?* This field is required.
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10
What's your occupation?* This field is required.This will give me an idea of how active you are at work and how much time you have to commit.
11
How many times a week do you spend $ on each? Fast food, Alcohol, Stimulants (coffee, tea, etc.) , Entertainment (concerts, movies, games, etc), Restaurants.
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12
On a scale of 1-10, how serious are you about achieving your goal? B* This field is required.1 - not serious , 10 - 100% committed
13
Are you the sole individual responsible for making financial decisions?* This field is required.If no, please list anyone who should be on our call.
14
How ready are you to invest in achieving your goals?* This field is required.Choose 1 only
Finances are not an issue, I'm ready to invest in my health and goals!
Money is tight, but if the program can guarantee results, I'm in!
I can't afford a program right now
15
My program is high value, HANDS ON, and leads to long-term life changing results. Industry standard rates for private coaching start around a few hundred dollars per month. Are you currently in a position to invest in your health and fitness?* This field is required.
Yes! 100%
Yes, but will need payment plan.
No, I'll keep winging it
16
How did you hear about me/my program?* This field is required.
17
Are you ready for your FREE 20 minute consultation?* This field is required.If not yet, you won't receive a reply.
YESNot yet.
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