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1. What is your name? (Required.)

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2. What is your phone number? (Required.)

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3. What is your email address? (Required.)

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4. What is your age? (Required.)

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5. What is your current occupation? (Required.)

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6. What is your current annual income? (Required.)

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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. (Required.)

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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? (Required.)

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

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10. Why are you interested in this program? (Required.)

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11. Why do you think you're a good fit for private coaching? (Required.)

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

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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. (Required.)

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