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This form is designed to effectively share your goals and help you reach them efficiently and in the safest and most sustainable way possible! To get in the best shape of your life or reach your goals and keep it that way. This is just an application and in no way obligates you to be part of or join anything.

**PLEASE DO NOT FILL OUT THIS QUESTIONNAIRE UNLESS YOU ARE SERIOUS AND READY TO GET STARTED AND MAKE A NEW LIFESTYLE**
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Full Name *
Phone number *
Email *
Social Media Contact
Age/Height/Current Weight *
What did you have for Breakfast yesterday? *
How many times did you eat yesterday? *
How often do you eat out per week? restaurants/fast food *
How much R / $ are you spending on food per week? *
What are all of your health and body goals? And why? *
Are you taking any supplements currently? *
If Yes to the Previous Question, which brand are you using? *
Do you drink coffee? *
Are you interested in earning additional part-time income from sharing your journey in reaching your goals? *
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