Men Only Application Contact Details Name Email: City State Phone Family Marital Status Married Single Describe your marriage/partnership/relationship in one word How would your partner/family support your health and personal growth? Career & Passions What do you do? What is your current job/career/business? What is your title/position? If you could do anything (if money, time, commitment to others didn’t matter) what would you be doing? What, if anything, is holding you back from your dreams? What does passion mean to you? On a scale of 1-10 (1 = minimal / 10 = intense)rate the following: Your job 1 2 3 4 5 6 7 8 9 10 Your daily duties 1 2 3 4 5 6 7 8 9 10 Your relationship with significant other 1 2 3 4 5 6 7 8 9 10 Your relationship with family 1 2 3 4 5 6 7 8 9 10 More about you What is your first thought upon rising in the morning? Using one word, describe your relationship with food Are you comfortable at your current weight? Has it always been this way? What is your biggest health challenge? If you could change one thing about your health, what would it be? If you could change one thing about your life, what would it be? Why are you filling out this application? What is it that you want to change, that motivated you to take the time for this application? If you knew that it was possible to look and feel better in your body by participating in a Sleeping Naked After 40 Custom Men’s Program, what, if anything, would stop you from working with me? If you were to be selected for one of my programs, what would have to happen at the end, for you to consider the program a success? Δ TweetSharePinShare0 Shares
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