Application - Xeniosfitness.com

First Name*

Last Name*

Email*

Phone*

Age*

Country*

Occupation*

Height*

Current weight*

Current Body Fat Level

What are the most important goals you want to reach with your fitness? And please explain why you need Xenios's help.*

What have you tried before that didn’t work and what is the biggest obstacle holding you back from reaching your goals?*

How are things going in other areas of your life (work, financial, relationships, etc.)?*

What is your profession?*

Do you have any health problems, current or past injuries?*

Are you prepared to take action RIGHT NOW to invest significant time, energy, and finances in yourself to reach your goals if you knew with 100% certainty that you would get there?*

Yes, absolutely! I am physically, mentally and financially ready for this!
No, I am not ready yet.

If you're accepted into our program how soon can you get started?*

Please select your call preference:*

Your Skype ID

What is your Facebook Profile Link? (Make sure is a link as we will add you as a friend)*

Our time is extremely valuable and we want to make sure that you will show up at your appointment. Do you promise to show up for your scheduled appointment ON TIME and DISTRACTION FREE?
Please confirm by typing, "Yes I will" in the box below.*

Do you have a positive attitude?
We only work and accept in our program people who are positive and want to help others.*