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* 1. What is your name?

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* 2. What is your phone number?

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* 3. What is your email address?

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* 4. What is your age?

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* 5. What is your current occupation?

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* 6. What is your current annual income?

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* 7. Tell me about at least two times in your life when you set a goal for yourself and achieved it.

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* 8. What are the most important goals (in terms of success with women) that you're looking to accomplish within the next 6 months?

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* 9. Why do you think you haven't accomplished these goals yet? (be honest)

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* 10. Why are you interested in this program?

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* 11. Why do you think you're a good fit for private coaching?

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* 12. What is the single biggest thing that you think I can help YOU with?

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* 13. If I pick you, are you prepared to pay the $2,000 fee this week and start immediately? If not, please do not submit this application. There are no installment payment options available and no exceptions.

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