First Name *

Last Name *

Phone *

I will text you details about the scholarship and important updates

Instagram Handle

Email *

What BEST describes your 6-month goals *

I want to lose some body fat (lose weight)

I want to build muscle & get more definition (gain weight)

A little bit of both! I want to tone up and lose some fat

Grow glutes

How would achieving this goal impact your life and what would it mean to you to reach your goals this year? *

What keeps you up at night or what information are you always looking for help with from ChatGPT or social media? *

How long have you been trying on your own to reach your goals? *

0-6 months

6-12 months

1-3 years

I feel like I have tried and done everything and it never happens for me

Occupation & How Many Hours Per Week You Work: (copy) *

How has your schedule impacted your health and fitness? *

What would you say is the biggest struggle for you in achieving your goals right now? *

Time management, nutrition, second-guessing your plan, etc

Which do you relate to the most *

Falling off every weekend and trying to start over Monday

Feeling like I am doing everything right but not seeing results no matter what

Always feeling "on" and "off" but never finding a good balance

Bingeing at night or struggling with a healthy relationship with food

Feeling like I am "almost" there but still falling short

Why are you ready to make the change now/this year? *

What would winning this scholarship mean to you? *

Why should YOU win this scholarship? *

What is your level of commitment to your goals and reaching them this year especially when it gets hard?

1. I’m extremely committed. I am sick of always looking for more information and searching for how I can make it happen.

2. I am committed, but don't want to miss out on life/social events

3.I know I want change, but I am not ready to commit to myself and goals

Although the full scholarship(s) are set and limited, some partial scholarships may be given away as well. If you qualify, are you interested in hearing about this possible opportunity? *

YES! I would love any opportunity to help make my goals a reality this year!

I would love to hear about the partial scholarship opportunities, but I am not 100% sold on committing to my goals this year

No, if it's not free my goals aren't worth it to me.

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