Short Application

Quickly help us understand how this accountability group will benefit you and what you will bring to the group

Name

Question Title

* 1. Name

Email Address

Question Title

* 2. Email Address

What is your gender?

Question Title

* 3. What is your gender?

Age?

Question Title

* 4. Age?

I heard about The Habit Factor via

Question Title

* 5. I heard about The Habit Factor via

I will bring..... to the accountability group

Question Title

* 6. I will bring..... to the accountability group

I'm hoping to gain... from the accountability group

Question Title

* 7. I'm hoping to gain... from the accountability group

My goals with The Habit Factor include...

Question Title

* 8. My goals with The Habit Factor include...

Twitter Handle:

Question Title

* 9. Twitter Handle:

I would like to join the group

Question Title

* 10. I would like to join the group

I am interested in small group coaching with Martin OR, a THF Certified Coach specifically for

Question Title

* 11. I am interested in small group coaching with Martin OR, a THF Certified Coach specifically for

I am currently using The Habit Factor app (ios or android) and tracking my habits

Question Title

* 12. I am currently using The Habit Factor app (ios or android) and tracking my habits

I agree to the following "RULES". I understand that not following them may result in the termination of my membership privileges. Please check ALL to demonstrate agreement/understanding.

Question Title

* 13. I agree to the following "RULES". I understand that not following them may result in the termination of my membership privileges. Please check ALL to demonstrate agreement/understanding.

T