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Weight Loss with Real Food Mentorship Application
1.
Please complete this application to be considered for Mentorship. Completing this application does not guarantee acceptance into the Weight loss with Real Food Mentorship Program. Once you submit this application, it will be reviewed. If you are accepted, you will be sent an acceptance email on 03/21 with a payment link of $99 for 30 days of Mentorship. When the payment is made, you will be added to the April roster. You will receive the Welcome Packet with instructions on how to prepare for Mentorship on 03/27.
Very clear
Not so clear
2.
First and Last Name
3.
What is your Facebook name? (First & Last)
4.
Phone Number
5.
Email
6.
What is your birth year?
7.
Height
8.
Do you have any current health issues?
Yes
No
9.
Are you seeing a doctor for any health issues? Does your doctor approve of you participating in a weight loss program?
10.
How do you think you would benefit from the Weight Loss with Real Food Mentorship program?
11.
Are you a picky eater?
Yes.
Kind of.
No.
12.
Do you feel that you need more knowledge with macro tracking and creating meal plans?
Yes
No
13.
Height
14.
Current Weight
15.
Goal Weight
16.
By completing this form you are agreeing to the following:
Meal planning: You will purchase groceries and prepare the meal plan you choose every week.
Fitness & Exercise: You will exercise at least 30 minutes a day.
Accountability: You will submit weekly weigh ins and complete daily exercise check ins.
Education: You will complete simple assignments and watch videos provided to help educate you on nutrition.
Encouragement: You will reach out to your coach, Sherri Boyd, on days when you need encouragement. You will not derail.
Agree
Disagree
17.
Refund & Deferment Policy: All refunds must be requested in writing to alexandrarealfood@outlook.com within 24 hours of monthly membership’s posted start date to be considered for a full refund. Deferment of start date is an option if notified within 72 hours of monthly membership start date. This would allow member to select a future month to participate in instead of current month and is not a refund of payment. No refund will be given if the member had access to the Weight Loss with Real Food Mentorship Facebook page for any given amount of time.
Above is our refund policy once paying the $99 after being accepted. Do you understand it?
If an exception is made for a member to join past enrollment closure, that it is for the remainder of the month paid.
Yes
No
Current Progress,
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