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The Crazy Blessed Health Club Application
Are you ready for a Natural Health Revolution? Then you may be a perfect fit for our Crazy Blessed Health Club!

Please fill out this form so we know how to best serve you; and one of us will get back with you within 24-72 hours to let you know next steps. NOTE: For time-sensitive enrollment (e.g., an expiring special that you want to get in on), please make sure you check the answer marked "URGENT" at the bottom of the application. These are given first priority.

Full Name
Your answer
Phone Number
Your answer
Best email address to connect with you
Your answer
Facebook URL
Your answer
Location
What is your current health situation?
Check any that apply:
Have you ever tried Zija products? (supplements, essential oils, etc.)
What level of accountability do you desire?
Please describe what you would love to get out of a personal "natural health revolution."
Your answer
Are you interested in building a business and becoming a natural health coach? (This is complimentary as long as you are an active member)
If you do want us to help you build a business, what is your current financial situation?
What do you feel is stopping you from achieving the health you desire?
Your answer
If applicable, what is stopping you from achieving the finances you desire?
Your answer
What is your biggest FEAR about being an entrepreneur (specifically, a natural health coach)
Your answer
Think about one year from today, and think BIG! What would you love for your life to be like?
Your answer
Which most describes you and your vision as a natural health coach
What best describes you?
We operate by Christian principles and use the Bible as our #1 success manual. On a scale from 1 to 5, how do you feel about this?
That bothers me.
I love the idea!
So.... What's NEXT?
Did a Zija distributor refer you to our program? If so, please tell us their name so we can thank them.
Your answer
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