Coaching Application Form
Name
First Name
Last Name
E-mail
Address
Street Address
Stre2
City
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Afghanistan
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Montserrat
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Nagorno-Karabakh
Namibia
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Nigeria
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Western Sahara
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Zimbabwe
Other
Country
Date Of Birth
-
Month
-
Day
Year
Date
Height
Weight
Body Fat%
*If known.
Do you have access to body composition measurement tools? Ie tape measure, calipers, dexa/INBODY scan etc
Yes
No
Which of these are available?
Do you wish to participate in future physique (bodybuilding/modelling) competition?
Yes
No
If ‘yes’ in the above, please specify any potential dates, specific events, if known.
Please list/describe any physical constraints, injury concerns, or mobility issues if any?
Please describe your CURRENT physical activity levels/details of any programs...
Include split/workout structure, periodisation plan, exercise selection etc. Please include as much detail as possible.
Please describe your PAST physical activity levels/details of any programs...
Include length of experience, style of training etc. Please include as much detail as possible.
Please list any previous sporting or exercise achievements...
Do you have available data on maximum efforts through KEY COMPOUND LIFTS (deadlift /bench/ squat) ?
Yes
No
Compound Lift*:
Barbell Squat
Barbell Bench Press
Barbell Deadlift
Barbell Squat*
Resistance
Repetitions
Barbell Squat
Barbell Bench Press*
Resistance
Repetitions
Barbell Bench Press
Barbell Deadlift*
Resistance
Repetitions
Barbell Deadlift
Please describe your CURRENT nutrition /details of any dietary strategies including a 48hour food recall...
Include typical food selections, daily/weekly patterns, calorie/macro nutrient intakes if known. Please include as much detail as possible.
Please describe your PAST nutrition/details of any strategies...
Include typical food selections, daily/weekly patterns, calorie/macro nutrient intakes if known. Rate effectiveness. Please include as much detail as possible.
List current supplement intake...
*If any.
Do you have any specific dietary requirements or food intolerances?
Yes
No
If ‘yes’ in the above, please detail these...
Are there any foods that you don’t like?
Yes
No
If ‘yes’ in the above, please detail these...
Do you consume alcohol?
Yes
No
Amount/Frequency?
How would you describe your current work/life/study balance?
Please self rate your current sleep hygiene...
1
2
3
4
5
Please self rate your current stress levels...
1
2
3
4
5
Are there any lifestyle factors/commitments that may provide interference to the implementation of any training or nutritional strategies, and if so could these mitigated?
Please upload any side/rear/front profile photos if available...
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Please add any other information that you may feel is relevant...
Please list best availabilities for a free 15min discovery call...
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