2 MONTH, 6 MONTH, AND 1 YEAR DATA ONLY
FOR CHALLENGE PARTICIPANTS

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* 1. Did you read the entire book (The ProportionFit Diet & Health Plan)?

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* 2. Did you register for the challenge when you started (you must register to qualify for prize money)?

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* 3. Which ProportionFit product did you purchase?

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* 4. How long ago did you start The ProportionFit Diet & Health Plan for this challenge period (choose the closest answer)?

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* 5. What is your current weight (in pounds)?

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* 6. How many pounds have you lost since starting The ProportionFit Diet & Health Plan?

0 100 200
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 8. What is your current waist circumference (optional)?

20 inches 70
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 9. How many push-ups can you do without stopping (optional)?

0 Push-ups 100
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 10. How many "chair squats" can you do in 60 seconds (optional)?

0 Chair Squats 80
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 11. If you qualify for prize money, who would you like the money to go to (any donations to charity will be made with recognition of the person who won the prize money)?

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* 12. How closely have you followed The ProportionFit Diet & Health Plan to lose weight?

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* 13. I certify that the results I am reporting here are valid and accurate and are primarily the result of following the ProportionFit Diet & Health Plan, and I accept that ProportionFit gets final say to determine the winners of the challenge:

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* 14. My name and email address is (for internal use only; will not be shared):

T