fitco 2 WEEK RAPID TRANSFORMATION PROGRAM

fitco 2 MINUTE APPLICATION form followed by payment.

All answers are strictly confidential including the essential medical questions.

All answers are required.

fitco Rapid Group Batch Selection

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Start Date 28 June

Thursday, 27 June 2024 - Application Deadline

Friday, 28 June 2024 - Orientation Week Start Date

Friday, 5 July 2024 - fitco TWO WEEK Rapid Transform Program Start Date

Monday, 22 July 2024 - End Program

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Start Date 26 July

Thursday, 25 July 2024 - Application Deadline

Friday, 26 July 2024 - Orientation Week Start Date

Friday, 2 August 2024 - fitco TWO WEEK Rapid Transform Program Start Date

Monday, 18 August 2024 - End Program

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Start Date 30 August

Thursday, 29 August 2024 - Application Deadline

Friday, 30 August 2024 - Orientation Week Start Date

Friday, 6 Sept 2024 - fitco TWO WEEK Rapid Transform Program Start Date

Monday, 23 September 2024 - End Program

Please select a fitco Rapid Start Date

fitco Rapid Start Date 28 June 2024 fitco Rapid Start Date 26 July 2024 fitco Rapid Start Date 30 Aug 2024

First Name

Last Name

ID Number

Phone Prefix

Mobile Number

Address Line 1

Address Line 2

City

Province/State

Country

Postal Code

What is Your Age?

Sex

Are you pregnant or suspect that you are?

Yes No

Do you have any specific dietary requirements or food allergies? (Enter "N/A" if not applicable)

Height in CM

Current Weight

Target Weight

What is your fitness level? (Rating of 1 - 4 with "4" being the highest)

1 2 3 4

What is your stress level? (Rating of 1 - 4 with "4" being the highest)

1 2 3 4

If you have selected "any other illness" please specify. (Enter "N/A" if not applicable)

Has any of your family been diagnosed, received treatment for, or suspect you have any of the following major illnesses? (Select all that apply)

I am currently using the following medications: (Enter "N/A" if not applicable)

I have had the following surgeries: (Enter "N/A" if not applicable)

Which of the following activities do you perform? (Select all that apply)

Brush teeth at least once daily Eat at least 3 meals a day Shower/Bath daily Bowel Movement daily Drink 2 litres of water daily Sleep at least 7 hours every night Cook at home at least 4 days a week Work less than 10 hours a day Grooming myself, including dressing appropriately and brushing hair daily

The full name of the person who referred me to fitcoNow (Enter "N/A" if not applicable)

To achieve a bigger transformation, invite a friend "fitco Buddy" to complete the fitco Rapid Transformation Program with you. The name of my fitco Buddy is

My fitco Buddy's contact number

Please enter any promotional code:

I give fitco permission to use pictures and data I have submitted to the services for marketing purposes

With Identification (Pictures will contain face and names will be mentioned) Anonymously (Pictures will not contain face and names will not be mentioned)

I would like to receive the fitco newsletter containing information regarding the program, including new foods that can be consumed and fitco events that are taking place near me.

Yes No

I have read and agree to the fitco Terms & Conditions

I agree

I have read an agree to abide to the fitco Code of Conduct

I agree

I am interested to join the fitcoNow team through a well compensated part-time Motivational role and have read the requirements of the fitcoNow Motivator Opportunity.

Join Team

fitco 2 WEEK RAPID TRANSFORMATION PROGRAM

fitco Rapid Group Batch Selection

Start Date 28 June

Start Date 26 July

Start Date 30 August

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