Applicant Information
For in person training with Millie Andrilenas NASM-Certified Personal Trainer, and Certified Nutrition Coach
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
How did you hear about me?
*
Please Select
Instagram
Word of Mouth
Friend/Family
Other
Instagram handle
N/A if you do not have one
Age
Sex
*
What services are you interested in
*
Personal Training (in-person)
Online Fitness Coaching
Nutrition Coaching
Exercise Performance Coaching
What are your fitness/nutrition/health/wellness goals that you have right now? Do you have a timeline?
*
What is the biggest struggle with your fitness right now that you want to work on?
*
Nutrition and diet
Feeling Confident
Gaining muscle
Loosing fat
Accountability
Knowing what to do in the gym
Other
Have you worked with a personal trainer or fitness coach in the past? If so, what was your experience like?
*
My current fitness level is:
*
Sedentary: little to no experience working out
Sporadic: random gym sessions; moderate gym confidence
Consistent but looking for more guidance
Other
Please provide your availability (dates and times) for a 30 minute consultation.
Anything else you would like me to know?
Should be Empty: