NEXT LEVEL IMPACT

Basic Information

Full Name *

Age *

Email Address *

Phone Number *

City / State *

Training & Health

Current Fitness Level *

Beginner Some experience Plateaued Advanced

Are you currently training? If so, where & how often?

Injuries / limitations / medical considerations

Energy & consistency (1–10) *

Intent & Commitment

Why are you applying right now? *

Biggest challenge (physical or mental) *

What does “Next Level” mean to you right now? *

Why coached training vs doing it alone? *

Readiness & Alignment

Training days per week *

2–3 3–4 4–5 5+

Prepared to invest in coaching? *

Yes No

Ready to begin *

Immediately Within 2 weeks Within 30 days

Agreement * I understand Next Level Impact is a commitment-based coaching program and not a drop-in fitness class.

Thank you for applying. We personally review every application and will reach out if there is strong alignment.