Online Coaching Application Form
Name
First Name
Last Name
Email
example@example.com
Instagram
Time Zone
Time Zone and Location
Gender
Male
Female
N/A
Age
Occupation
Health and Medical History
Do you have any pre-existing medical conditions or injuries? (e.g diabetes, asthma, joint pain, past injuries etc) If yes, please specify, if not insert NIL in the box.
Are you currently taking any medications? (Yes or No, if yes please list them)
Have you ever been advised by a doctor to avoid any specific types of exercises? (Yes or No, if yes, please explain)
Training History
How would you describe your current powerlifting level?
Beginner/Novice (less than 1 year of experience, needs a lot of care, loads of room to improve)
Intermediate (more than 1 year of experience, knows a thing or two, wish to compete soon)
Advanced (more than 2 years of experience, knows what I am doing, competitive)
What is the weight class that you are currently competing in/aiming to compete at?
Tell me about yourself and what interest you to apply for online coaching with Clinton
Describe your current training frequency and routine. Or email your past training program to clintonleejq@gmail.com
What is your current struggles in training?
Which exercises and rep ranges have worked extremely well for you? (squat, bench press and deadlift)
Please describe your thought process and cues for Squats (include stance, foot angle, bracing strategies, descending and ascending strategies)
Please describe your thought process and cues for Bench Press (Include grip width, setup process, understanding of how to get to bottom position, leg drive strategies)
Please describe your thought process and cues for Deadlift (specify sumo or convi, include setup thought process, execution process)
What is your current 1RM for Squat?
What is your current 1RM for Bench press?
What is your current 1RM for Deadlift? (specify sumo or convi)
What is your primary goals in powerlifting? (list down also your goals for squat, bench press and deadlift 1RM)
What competition do you currently have in mind that you wish to compete in? (list down the name and date of the competition)
Have you ever hired an online coach before?
Yes
No
If yes, how was your experience like with your previous coach? What do you think you are looking for when hiring a new coach?
Submit
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