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Results Measures Questionnaire

Please take a moment to fill this form out in detail...

Before we begin, I'd love to get a little more information about you. Please take a moment to fill out the form below so we can update your file and get a measure of where your results are currently.

*All fields are required*

Birthday

Shipping Address

Facebook Handle

Instagram Handle

What industry are you in?

Do you own a business or work for someone else?

What is your goal, within 6-12 months from now?

What is your income goal and what is your current income?

On a scale of 1-10, how committed are you to your goal?

T-Shirt Size Unisex, true to size, prewashed

Sweatshirt Size Unisex, true to size, prewashed

Why did you say 'yes' to this program? (By answering this question, you are helping our team deliver on our promise to you)

Please take a moment to fill this form out in detail...

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