BodyTrim Online Application Form
​Thank you for your interest in ​BodyTrim Online. Please fill the application form below to get started.​​ After receiving and reviewing your application, I'll send you a messagel to let you know if you're eligible for the programme or not.
First Name *
Your answer
Last Name *
Your answer
Email Address *
Please fill in the email address you check regularly
Your answer
Your Phone Number *
Your answer
Country of Residence *
Your answer
Current Weight *
Your answer
Goal Weight *
Your answer
Gender *
Age *
Your answer
Do you have any existing medical condition that will make it dangerous for you to exercise? *
If we were to meet 60 days from today, what has to have happened for you to feel happy with your weight loss progress? *
Your answer
Since you know yourself better than anyone else, what would you consider the top 2 things that need to change or have to happen for you to get there? *
Your answer
How many times do you currently exercise in a week? *
How physically active is your job ? *
Considering your current schedule, can you make time to exercise for 30 minutes 4-5 times a week? *
The programme is 100% online, do you know that? *
On a scale of 1–10, how important is it for you to lose weight now? *
Not Important
Very Important
Do you have any questions for me?
Your answer
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