APPLICATION FORM First Name Last Name Email Age Favorite TV Show of All-Time Name one song that should be on every playlist Gender What do you do for a living Phone Number / Skype How ready are you to start making changes NOW to reach your goals? I’m ready to do whatever it takes! Change doesn’t scare me.I think I’m ready, but the idea of change is a bit overwhelming at times.I want to be ready, but I always procrastinate and get stuck in a rut.I’m not ready. I need to sort out a few things first and then I can start to think about change. Why do you think online coaching with me will work for you? Do you have any medical conditions or previous injuries? What’s your all-time favorite food? Are there any nutrition restrictions, allergies, or dietary protocols that you follow? Tell me a bit about your exercise experience in the past and at present. Have you had a coach before? Yes No If you are accepted into the coaching program, are you ready to start NOW? I was ready yesterday. I have a few things to get in order first. How’s next week? I’m gonna need some time to think about it. Let’s Do This!