Private Nutrition Coaching Application Question Title * 1. Please enter the following information so that I may get to know you better. Name: * Address: Address 2: City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: * Email Address: * Phone Number: Question Title * 2. How old is your youth ice hockey player and what is their gender? Question Title * 3. How long has your child played? What is their current level of play: ex: Pee Wee AA, Squirt House B Select. Question Title * 4. I need to know some items to calculate your child's optimal protein needs. Please consider your answers carefully as it will impact my calculations. Thank you.What is your child's weight in pound or kilograms, height in feet and inches or meters. Question Title * 5. How many times a week does your player eat fast food? Examples: McDonald's, Burger King, Arby's, Bo Jangles Question Title * 6. How many 8 ounces servings of milk does your child have every day? (Not cheese, just fluid milk) Question Title * 7. What is your child's favorite meat? Ex: poultry, fish, beef, eggs, pork, or vegetarian choices Question Title * 8. What are your short term goals for your youth hockey player? Ex: faster skating, more stamina, fewer cramps, more focus, greater speed, added strength) Question Title * 9. What are your long term goals for your youth hockey player? (Juniors, College Scholarship, AA team, AAA team, NHL, etc) Question Title * 10. What is the number one goal you would like your youth ice hockey player to achieve if you decided to work with Kim, Hockey Mom RD? Done