Rapid Results Coaching Program - Training and Nutrition Questionnaire

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Rapid Results Coaching Program - Training and Nutrition Questionnaire

Hey Team!

Please take 2 minutes to fill out the short application below to help us learn more about you and your goals for your physique, health and performance.

Once you submit your application, we will review it and if for any reason we don't think you're a good match, we'll let you know. Otherwise, we'll follow up via text to discuss the possibilities for working together.

If at any point you decide now's not the right time, or it's just not right for you, no problem, there's no pressure from us.

What is your first name? *

What is your last name? *

Please select your age range *

< 25

25-30

30-35

35+

What is the BEST email address for me to contact you on? *

What is the BEST number for me to contact you on? *

Which city and country do you reside in? *

Which of the following best describes your current physique? *

Skinny

Skinny-fat

Medium build, some fat

Medium build, no fat

Lots of muscle, some fat

Lots of muscle, no fat

Overweight

What is your top training/nutrition/fitness goal for the next 120 days? *

In your opinion, briefly explain the ONE main thing stopping you from achieving your goal selected above? You can say things like 'I need accountability' or 'I don't know how to train effectively'
*

Are you aware that working with Rebel Performance is a minimum 12 week commitment so that we can get you in the best shape of your life? *

Yes, and I am happy to proceed

That sounds like it's not for me

What is your job title/role? *

Approximately, what is your after tax monthly income? *

<$2500

$2500-$5000

>$5000

Our program's not the cheapset however we teach you the knowledge you need to be sustainable for the rest of your life. With that said, if you feel like it's a good fit and what you need, are you willing to invest financially to reach your goals? *

YES

If you decide you'd like to work with Rebel Performance, how soon are you looking to get started? *

Now

Later

I understand that after submitting this form a team member from Rebel Performance will follow up via text to discuss the possibilities for working together. *

Yes, and I am happy to proceed

That sounds like it's not for me

Submit

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