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Application Form

Name *

First

Last *

Last

Address *

Address Line 2

City *

County

Postal Code *

Country

Email *

Telephone Number

More about You

What do you want to achieve in your health and fitness? *

What would it mean to you to achieve this? *

How much do you think you have spent trying to achieve your goals? *

How does that make you feel?

What challenges and obstacles have you faced when trying to reach your goals in the past and why do you think you are not at them at the moment? *

How do you feel about your body right now on a scale from 1 to 10? (1 being lowest, 10 being highest) *

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How motivated are you on a scale of 1 to 10 to do something about this now? (1 being lowest, 10 being highest) *

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What are your energy level like right now on a scale of 1 to 10 (1 being lowest, 10 being highest)? *

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What size are you currently? (Yes this is a personal question!)

I do not work with every client as I am very selective who I let in my training groups. It is important that I work with like minded dedicated clients so that I can help you reach your goals in super quick time.... Why should I pick you? *

What have you tried in the past? Has it worked, what didn't work? *

What has made you fill in this form today? (Please be as detailed as possible) *

Which services most appeal to you? *

Personal Training

Inspirational Ninjas Body Transformation Camp

No Lycra Allowed (Size 16+ only)

Boxercise

Massage

What are you looking for from a weight loss programme? *

Sustainable weightloss and toning

Support and guidance from a like minded group

Nutritional Support

Non intimidating environment

People asking if I have lost weight

All the above!

Why have you chosen Inspirational Fitness, Personal Training/Inspirational Ninjas weight loss camp instead of the cheaper pay as you go options around?

How did you hear about Inspirational Fitness and Health?

Facebook

Twitter

Linked In

Network Cornwall

Article in local paper

Recommendation

Flyers

Search Engine

Other

If other please state and If you have been referred please state the name of the person who referred you?

Finally, Which of the following best describes you?

Excuse maker that always looking for a magic pill

Procrastinator that always puts this off

An action taker that wants to make changes now

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