Mentor Training Program Preliminary Assessment
First Name *
Last Name *
Phone *
Email *
Mailing Address *
Age *
What area of mentoring are you interested in (list as many that apply to you) *
Why are you considering becoming a wellness ambassador/mentor? *
If you have been an annual or monthly member of WLGW, how long have you been a member? *
Which WLGW courses have you taken? *
What skills do you possess that would make you a great mentor? *
Do you have any previous experience leading groups or mentoring others? Please give details. *
What are your personal health goals? *
On a scale of 1-10, how knowledgeable would you say you are in the Healthy by Design/WLGW Principles? What principles has most impacted your life *
Describe your health journey? *
Describe your faith journey? *
What is your current weight? What is your desired weight? *
What accomplishment are you most proud of in your life? *
What weight loss programs have you taken in the past? *
What country are you in? Do you speak any other languages? *
What time zone are you in? *
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