CLO Mentorship Application

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Clean Living Online is for busy individuals over 30 years who want to lose 10+ kgs for the long term. If accepted, are you willing to invest in expert coaching?* This field is required.This is personalised coaching that fixes why your past attempts didn't work.
✅ YES❌ NO
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We have a 2 Step process application to make sure you are a good fit for the Clean Living Online Mentorship. Step 1 - Is this application (please answer honestly). Step 2 - A 1-on-1 Zoom Consultation Call (book at a convenient time for you). Do you want to proceed?* This field is required.
✅ YES - I'm ready for both steps❌ NO - Not right now
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Learn the proven framework that has helped 500+ busy people just like you lose weight for good. ✅Discover how it works for your body, even in (peri) menopause, without cutting your fav foods or starving yourself.
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What is your goal right now?* This field is required.Choose as many as you like.
Lose fat + feel confident again
Improve energy and overall health
Fix cravings + emotional eating
Build strength + tone up
I want a full lifestyle reset
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How long have you been trying to lose weight?* This field is required.
Less than 6 months
6-12 months
1-3 years
3-5 years
5+ years
Most of my life
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If you qualify, you'll unlock a free consultation call with our team.We will talk you through how the CLO Weight Loss System can help you lose 2-5kg per month until you hit your goal.
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What feels like the biggest things that are holding you back right now?* This field is required.Please select all that apply
I don't know what to eat consistently
I start strong then fall off
Stress/Sleep/Exhaustion
Hormones, Menopause symptoms
Snacking/Binges/Cravings
I feel like nothing works any more
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What have you already tried to lose weight or improve your health?* This field is required.Select all that apply
Personal Trainer or in person coaching
Online Coaching Programs
Nutritionist or Dietitian
Calorie tracking/Macros
Structured Diets (Keto, Low carb, fasting...)
Apps or Programs
Blood work or hormone testing
Supplements
GLP-1 Medications (Ozempic, Wegovy, etc)
Self guided attempts - Doing it on my own
I've tried, but nothing has stuck
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Why do you think these have not worked for you?* This field is required.Select all that applies
Too restrictive
No Structure / o Plan
Inconsistent routine
Emotional eating
Other
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Better Fat Loss. Better Health. Results for a life time.Here is how CLO Mentorship compares over 6 months...
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12 months from now i want....* This field is required.Think of how you look, how you feel, how clothes fit, confidence and health. Paint the picture.
To feel confident in my body again
To have consistent energy and feel like 'me' again
To stop obsessing over food and weight
To finally keep the weight off for good
To stop hiding and being ashamed of my body
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How motivated are you to solve this for good? 🔥* This field is required.
2/10 - I am not interested in making progress. I am happy staying where I am.
5/10 - I know I need to do something, but I m not will to change.
7/10 - I am frustrated, overwhelmed and I want to start NOW!
10/10 - I am all in, I am DONE waiting and am ready to follow through.
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How old are you?* This field is required.
24 or under
25-29
30-39
40-49
50-59
60+
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What country do you live in? 🌎* This field is required.
Australia 🇦🇺
UK 🇬🇧
USA 🇺🇸
Rest of world 🌎
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What is your current weight?* This field is required.Answer in kgs
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What is your Height?* This field is required.Answer in cm
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What is your goal weight?* This field is required.Answer in Kgs
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Have you ever been diagnosed with an eating disorder?* This field is required.Its important for us to coach with integrity and sometimes may need to refer to another service that meets your needs if we believe they are out of the scope of our practice.
YESNO
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What is your current occupation? * This field is required.What you do for work has a huge impact on your daily routine and effects the programming.
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What is your Instagram handle?* This field is required.Example: @benclaypole
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Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Congratulations, you qualify for a free Consultation Call with our team. This is the 2nd phase of the application. The next page will be a link to our diary for you to choose a time for your short Zoom Call. 🎉On this call you will be able to ask our team any questions that you have about the Mentorship and we will find the information we need to help you understand everything so that you can make an informed choice about joining.
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**Please remember to press SUBMIT (bottom right corner) after you have booked your call date/time**You will be emailed your confirmation and your booking link. Please make sure you have entered your email accurately so that it's sent correctly.
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