Accountability for Remote Workers In-Take Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thanks for your interest in group accountability! Please note that you will not be charged anything for filling out this form. I will reach out to further discuss details as your group forms. Once you commit and your group is ready to launch, I will send you an invoice!

Email *

What is your name and where are you from!?

How did you hear about Accountabilibuddy For Hire Services?

We can work on clearly defining your goals, but I want to know where you are right now and where you are struggling the most.

What motivates you? (rewards, acknowledgement from others, etc)

How do you think working this program will help you the most?

When are you available to meet for our weekly group check-in? Mark any options that are consistently available in your schedule so you don't miss a session!!

Monday 5:45pm EST

Tuesday 5:45pm EST

Tuesday 9:00pm EST

Wednesday 8:30pm EST

Wednesday 9:30pm EST

Thursday 9:45pm EST

Saturday 9:00am EST

Sunday 10:15am EST

Sunday 9:30pm EST

Other:

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms