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1. What's your first and last name? *

*

2. How old are you? *

3. What is your primary goal? *

4. As your coach, I will CARE MORE about your progress than anyone. Are you at a point where you can absolutely commit to your goals? *

Yes

No

5. What would be the biggest thing holding you back from achieving your goals? *

6. What’s the best number to reach you? (Including area code) *

7. How are you approaching this application? *

I need something hands off & very affordable.

I'm looking for soemthing more customized that gets better results.

I want custom 1:1 coaching & I'm ready to go all in.

8. What is your Instagram handle OR Facebook name? *

9. Please leave your email address *