Application for Coaching

First Name *

Last Name *

Instagram Handle *

Date of birth *

Phone *

Email *

Which of the following best describes your current goals/challenges? (select all that apply) *

I want to lose fat (lose weight)

I want to build muscle (gain weight)

Improve performance (strength, endurance, etc.)

I want to improve my overall health, increase energy, etc.

I want to learn skills to improve my mental strength.

I want to improve my relationship to stress.

I want to sharpen my leadership skills.

What is your commitment level to your personal results? *

1. I’m extremely committed and want to make a change. I will do whatever it takes.

2. I’m committed enough to invest in my goals, but I’m afraid of how much time it will take.

3. I know I need help to make a change but I’m not sure if I’m ready to fully commit.

Anything else you'd like to add?