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* 1. First and last name

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* 2. E-mail address

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* 3. Phone number (optional)

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* 4. Age

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* 5. Current relationship status

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* 6. Occupation

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* 7. Annual Income

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* 8. Where are you based? (City and country)

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* 11. Based on the last 6 months - how often are you having sex?

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* 12. In a few lines, describe your sex life as it is.

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* 13. If anything was possible - describe how you would like your sex life to be.

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* 14. What do you think is holding you back from having the sex life you really want?

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* 15. What other key goals do you have for your life in general?

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* 16. What needs to change in the next 90 days for you to achieve your goals?

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* 17. If you knew with absolute certainty that Lawrence could help you find total fulfillment through sex, what would that be worth to you?

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* 18. What will happen if you don't take the required action towards creating the sex life of your dreams and experiencing sexual fulfillment?

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* 19. If your application is approved, do you commit to showing up to your call on time?

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* 20. Do you have any other questions or comments you would like to add?

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* 21. Final confirmation:

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