Direct VSL App

1

Did you watch the full video?* This field is required.It is crucial that you go back and watch the full video - You need to understand exactly who this is for before submitting your application.

Yes

No

3

How much weight do you want to lose for good?* This field is required.

Less than 15 lbs

15-30 lbs

31-50 lbs

50 + lbs

4

When were you in the best shape of your life?* This field is required.

Last year

2-5 years ago

More than 5 years ago.

I've never been in great shape.

5

Imagine it's one year from today. Which of these do you want to be true? (Select all that apply.)* This field is required.

I finally lost the weight and kept it off.

I have more energy than I've had in years.

My family has the best version of me again.

I feel confident every time I put on my uniform.

I stopped making excuses and finally took control of my health.

6

If you're accepted, are you open to investing in yourself if we believe we're a good fit?* This field is required.

I'm ready to invest if it's the right fit.

I'd need to explore payment options to make it work.

I'm not looking to invest right now.

7

Full Name* This field is required.If you qualify, we need the correct contact information to reach you.

First Name

Last Name

8

Email* This field is required.If you qualify, we need the correct contact information to reach you.

example@example.com

9

Mobile Phone Number* This field is required.If you qualify, we need the correct contact information to reach you.

10

LAST STEP: If you're accepted, the final step is scheduling your 1-on-1 Zoom call with one of our coaches. During the call, we'll learn more about your goals, answer your questions, and build your personalized game plan. Can we count on you to schedule your call and show up?* This field is required.

Yes. If I'm accepted, I'll schedule my call and be there.

Cancel my application. I don't want to get on a call.

11

Calculation

12

By Clicking "YES" You grant us permission to communicate with you via email, text, and phone. You will be able to opt out at any timeBy clicking no, you will be disqualified from our 1-1 coaching program automatically as we will have no way to contact you.

YesNo