Application to be coached by Dave

Full Name:
City & State: Zip:
Cell Phone:
(I will text you occasionally
while coaching you)
Your Age:
Weight: Height:
Your Gender: Male Female

What would you like to weight?
How many weight-loss programs have you tried in the past 5 years?
Why is it important to you to lose weight permanently?
Will you have 60 minutes total per day for your personal development and weight-loss goal? not sure hopefully absolutely
Will you be able to prioritize your weight-loss goal in your life? not sure hopefully absolutely
How many months are you willing/able to commit to Dave coaching you?
Check off what causes you stress in your life: your finances your spouse your career/business your kids other (please describe below)
and why?
Are you "open-minded" to ideas & beliefs that are different than what you currently have?: never sometimes most of the time always
Why do you believe Dave should select you as a person who will benefit from his coaching & teaching?