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Full Name
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Email address
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Best number to reach you
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What is your main goal for the Coach Certification Program?
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Stop eating emotionally
Become a weight loss coach
Improve my coaching practice
Change careers
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If you had a magic wand, what would you change about yourself or your life?
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Please list your dreams and desires here
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Do you currently have a coaching practice?
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Yes, and I've got tons of clients
Yes, but I'd like more clients
Not yet but I'm working on it
No but I'm interested in starting one
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What is your skill level with EFT/Tapping?
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It doesn't matter if you are certified, we just want to know how comfortable you are with the modality
Beginner
Intermediate
Advanced
I use EFT in my coaching practice
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What other modalities are you familiar with? Please list years of experience and skill level.
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If we help you completely transform your body and life will you help us spread the message by submitting before and after photos?
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Yes
No
I'm not here to lose weight
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Are you willing to commit to your transformation?
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This program requires a significant investment of your time, energy, dedication and cash (think 4 figures). We will help and support you every step of the way, and ensure that it's worth every last drop of effort. Are you willing to commit?
Yes, I'm so ready
I can't make a commitment at this time
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How much are you able to invest in your education at this time?
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$1500 - $3000
$5000 - $7000
$7000 - $10,000
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