Strong Women Fitness Application form Strong Women Fitness aims to only work with women who are serious about making a lifestyle change Question Title * 1. Name Question Title * 2. Date of Birth date Date Question Title * 3. Contact Details Email House / flat, name / number Street Town / City County Post Code Question Title * 4. What are your top weight-loss, health or fitness goals? Goal 1 Goal 2 Goal 3 Question Title * 5. Your fitness experience What have you tried before? What went well? What didn't go well? How Important is it to overcome your obstacles and achieve your goal? What Road Blocks are slowing you down from achieving your dream body? Question Title * 6. What is your current diet like? Mostly processed foods / takeaways Mix of processed and fresh All cooked from fresh Restricted Calorie intake Question Title * 7. How much would you be willing to invest in achieving your primary goal if you knew you would 100% achieve it & how long would you like to work together Up to £150 a month Between £200 - £300 a month Between £300 - £500 a month 4 months 6 months 12 months Question Title * 8. If you are selected to work with Strong Women Fitness, is there anyone else to clear the investment, or do you anticipate being able to make the decision for yourself? There's someone else I need to clear this with I can make the decision for myself Question Title * 9. Because Strong Women Fitness offer a unique, exclusive, customised-to-you, high touch program, I only work with a small amount of individuals, so my availability is very limited. Feel free to take this opportunity to add any additional notes on yourself too. Submit