Physical adj.- of or relating to the body; having material existence; perceptible especially through the senses and subject to the laws of nature

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* 1. First Name

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* 2. Last Name

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* 3. Type of activity:

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* 4. Date

Date

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* 6. Describe the activity. In what ways did this activity further your physical success? 

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* 7. What other areas of success (mental, spiritual, financial, creative, or social) does this activity challenge you in?

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* 8. What was the most challenging part of this activity? How did you handle it?

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* 9. Share the details of a mentee/mentor/partner/professional/witness that shared this activity with you.

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* 10. Is there a photo or document to evidence this activity?

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On a scale from 1 (least/rarely/no) to 5 (most/always/yes), rate your current physical success for the following items:

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* 11. I recommend this activity to others who want to achieve physical success.

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* 12. I am satisfied with my physical success.

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* 13. Can we share your success with others?

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