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Please complete this application to be considered for the next Fit Old Man cohort/group.
Let's Begin
Who are you? *
What's you BEST email address? *
We need to be able to reach your inbox...
What's your BEST number?
Yes, expect a phone call.
How did you hear about Fit Old Man?
A friend
FOM Website
Facebook
Twitter
Instagram
Search Engine
How important is your health? *
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Why? *
Why is it important?
How likely are you to commit to and STICK with a comprehensive men's health program? *
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Why now? *
What's kept you stuck? *
Prioritize your limitations...
Accountability
Commitment
Discipline
Strategy
What do you have access to? *
Tell us about your ability to participate. Please select all that apply.
Computer
Chrome or Safari Browser
Web Cam & Mic
iPhone or Android Device
Google Drive or Dropbox Account
iPhone or Android Device
What kind of Men's Health information do you find MOST useful/valuable? *
Accountability
Articles
Coaching
Events
Podcasts
Product & Service Reviews (Videos)
Webinars
What are some of your favorite Men's Health websites, blogs, podcasts or video channels?
Why?
Specific to Men's Health, what resource do you feel is missing?
Done
THANK YOU! We appreciate your time and attention.
We will be in touch... real soon.
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