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TMLR Interest Form (v.2021.10.0)

Hello. Thanks for your interest in The Midlife Reset

Click the Let's Start button to register your interest in The Midlife Reset.
After you submit this, we will contact you with more details.
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Hey there, my name is Jonathan. I'm the head coach and founder here at Legacy Coaching.
Click "GO" and let me know about you ...
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2
What is your FIRST NAME?
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3
... and your LAST NAME?
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4
Thanks {{ 2. What is your FIRST NAME? }} . How did you discover Legacy Coaching?
  • A I heard about you through a podcast
  • B I've seen you on Facebook
  • C I was just clicking around the interwebs ...
  • D A friend told me about you
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5
Why is now the right time for you to reset your life?
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6
Is there a specific issue/challenge that you are wanting to overcome?
  • A NO
  • B YES
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7
How long has this been a challenge for you?
Rough estimate, please
  • A A few MONTHS
  • B A few YEARS
  • C 3-5 YEARS
  • D 5-10 YEARS
  • E More than 10 YEARS
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8
How big of a problem is this for you?
Drag the slider to the appropriate level (0 = low, 100 = high)
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9
What's your best email address {{ 2. What is your FIRST NAME? }} ?
We NEVER spam
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10
Oh, and one last thing ... have you ever worked with a coach before?
  • A YES
  • B NO
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Thank you for your interest and for taking the time to let us know a little more about you.

We will contact you shortly with more information or the next steps.

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