Coaching Application

Application for 1:1 Coaching

1. Yes Amy! I want to work one to one with you, for 90 days and gain full access to your coaching, guidance and expertise within No-Diet Solution+. I understand that you will use this application to select a small handful of individuals who are committed to transforming their mind and body, to reach their ideal weight and that you will let me know within 5 business days if I have been selected. *

I agree

* Indicates required field

2. Today's Date *

3a) Name *

First

Last

b) Address *

Line 1

Line 2

City

State

Zip Code

Country

c) Email *

d) Phone Number *

e) D.O.B. *

f) Best way to contact you *

4. I understand that I will be charged a REFUNDABLE deposit of £350 to demonstrate my commitment and reserve my place in No-Diet Solution+. If I am not accepted, this deposit will be immediately refunded. *

I understand

5. Please choose your desired Payment Plan *

I understand my £350 deposit will be deducted from my one time payment of £2000 I understand my £350 deposit will be deducted from my first payment of £700, followed by 2 further monthly payments of £700

6. Describe your current situation and eating habits *

7. What have you previously tried in an attempt to lose weight? *

8. What are the three biggest obstacles stopping you from reaching your ideal weight? *

9. What is your current weight? *

10. What is your ideal weight or dress size? *

Submit

Application for 1:1 Coaching

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