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Awaken's Support & Challenge Group Application
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First Name
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Your answer
Last Name
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Your answer
Email Address
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Your answer
Country (US & Canada Only)
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Choose
United States
Canada
Phone Number
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Your answer
What are your current health, wellness, and fitness goals?
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Your answer
Describe your eating habits. (e.g. What, How much, When, etc.):
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Your answer
Do you exercise regularly and/or participate in any physical activities/sports?
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Your answer
Describe the stress levels of your daily life:
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Your answer
Do you have any health challenges that you are facing?
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Your answer
Why do you want to be a part of this group?
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Your answer
How would you rate your current fitness level:
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Choose
Beginner
Intermediate
Advanced
What is the best way to contact you?
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Any additional information you would like to add?
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