Name

Email

Cell Phone

Home Phone

Business Phone

What is your goal weight?

When can you begin?

What days?

What times?

Height?

Weight?

Body fat % if known?

estimated goal time? calculator

Question or comments:

How did you find us?

LVAC gym, LVAC website,
LVAC employee, LVAC group instructor,
LVAC trainer guide, LVAC magazine,
LVAC sales counselor/manager,
brochure or flyer, online search, friend,
met me in person, television ad, radio ad,
saw me at the gym, picked up business card,
T-shirt on me, T-shirt on client,
saw business ad on my car,
current client, past client, doctor,
physical therapist, chiropractor,
massage therapist, yellow book, MYSPACE.COM,
Shape magazine, Oxygen magazine,
Muscle and Fitness, Oprah show,
IDEA health and fitness conference,
National Academy of Sports Medicine,
Article in newspaper, Photographer, Web designer,
Realtor, Loan Officer, Central Christian Church,
24 Hour Fitness, Gold's Gym,
Group Instructor, other trainer,

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