Why Did I Ditch My 9-5?

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First and Last Name: *

Email Address *

City and State of Residence

Facebook Link

Would you consider yourself a motivated individual?

Yes

Not really

I need a kick in the pants every once in awhile

Clear selection

Are you able to commit to your health while helping others commit to theirs?

Yes

I have a condition that may hinder me

Clear selection

What would an extra $500 - $1000 a month mean to you and your family?

Elaborate as much as you'd like. The more, the better!

How many hours per week are you willing to dedicate to your business?

Less than 5

5-10

10-15

15+

Clear selection

Which one best describes your best situation?

I currently work full time

I currently work part time

I am a stay at home parent

I work more than one job

I am unemployed

Other:

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Which one best describes why you are inquiring about this opportunity?

I want to make extra money for groceries

I want to replace my part time income

I want to replace my full time income

I want to make 6 figures

I want to take over the world (insert evil laugh here…. just kidding!)

Clear selection

How much money are you able to invest in your health/weight loss/fitness right now?

No more than $40

$40 to $100

$140 to $180

$200 +

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Have you ever done an at home Beachbody workout program before?

Insanity, P90X, Turbo Fire, Hip Hop Abs, Brazil Butt Lift, 21 Day Fix…. the list goes on.

Yes

I have never heard of these programs.

Other

Clear selection

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