Mike Basile Personal Training Application Form
In order to help you come out with the best plan for you, we just need a little bit of background info.   Try to be as accurate as possible with your information.  If you're not sure, no worries!
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Name *
Email Address *
Mobile Number *
Sex *
Date of Birth *
MM
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DD
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YYYY
Height *
Weight (if known)
Briefly describe your exercise history *
For example: Sports you've played, gym memberships etc
Do you have a specific goal or event you'd like to aim for as a target? Do you have a specific reason for looking into online training?  If so, let us know what it is! *
Your goal could be anything - a specific weight, an event such as a wedding you want to look good for, or even something like running a marathon!
Current Activity Level *
Do you currently know how many calories you eat per day? If yes, how many? *
What exercise equipment do you have access to? *
Tick all that apply
Required
Do you have a set of scales to weigh yourself? *
Do you have a set of kitchen scales? *
How would you like us to contact you? *
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