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* 1. What is your:
Name
Age
Email
Phone

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* 2. If you could snap your finger and fast forward 1 year from now, how would your life and health be different?

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* 3. What are 3 things you are worried about not being able to do 10 years from now?

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* 4. What days and times work best for you to train at the Transformation Center across from Memorial High School near West Town Mall?

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* 5. If we are able to reach all your goals and much more are you able to afford semi private training and nutritional coaching for $19-$32/session?

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* 6. Anything else you would like us to know about you?  We will follow up with you in the next 24 hours. 

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