Initial 1on1 Call Application Form

1

Which of these options best describes your current situation?* This field is required.

Recently came out of a breakup.

Little to no dating experience.

I can attract some women, but not the ones I like the most.

2

What's your name?* This field is required.

First Name

Last Name

3

What's your best email {name:first}?* This field is required.

example@example.com

4

{name:first}, in which city or town do you live?* This field is required.

Your city or town

5

Age* This field is required.

Your age

6

What do you do for work, {name:first}?* This field is required.

7

What's your current annual income?* This field is required.All information stays private, we ask this to get context on your current situation.

Under $50,000

$50,000 - $100,000

$100,000 - $250,000

$250,000 - $500,000

+$500,000

8

What best describes what you really want in your dating life?* This field is required.

High quality dating in abundance: meeting and connecting with multiple attractive women naturally and honestly.

A healthy, committed relationship with your ideal woman.

Unshakable confidence and social freedom: feeling calm, attractive and in control in any situation.

9

What is the biggest obstacle preventing you from achieving this right now?* This field is required.Don't overthink - just write what comes to mind.

10

I'm very selective with who I work with: my goal is to get everyone incredible results. Based on what you've seen, why do you feel that I might be able to help?* This field is required.

11

{name:first}, what is your phone number?* This field is required.

Your phone number.