The Whole Life Manifesto Coaching Program
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A little bit about you...

Please note, all responses are private and confidential and kept between you and the 'Whole Life Manifesto' coaching team. We encourage you to be as open and honest as possible.
 
What is your First Name? *

 
What is your Last Name? *

 
What is your mobile phone number? *

 
Where did you hear about us?


 
Where do you live?

City & Country
 
What is your Relationship status?

We realize that relationships are not always black or white. Please feel free to select the best option below or provide a short response in the "other" section.

 
How old are you?

We're referring to your total years on this planet.
 
How old do you FEEL?

This is your real age in our opinion.
 
How would you rate your current state of health? *

Recognizing 'health' is a very subjective term, in this program, we look at health as an overall combination of optimized body, mind, and spirit.

"10 thumbs up" is living in a state where you feel you're completely happy with your current physical, emotional, and spiritual state.










 
When was the last time you felt great about your 'health'?

We know that 'life' happens and things change. We get focused on school, career, family, social commitments, and tend to put our health on the backburner... and then time does what it does, and next thing we know, we wake up and wonder where the last 5, 10 or 20+ years have gone... can you recall a time in your life when you felt your 'healthiest'? Please tell us a bit about that.
 
Let's talk about Your Body, Mind, and Spirit for a second...

 
How would you rate your current state of 'nutrition'?

Nutrition affects mood, hormones, energy, concentration, productivity, and influences every aspect of our physical, emotional and spiritual being. What we put in our bodies determines whether we are thriving or just surviving.
 
How will you feel once you've moved your 'nutrition' rating closer to '10'?

 
How would you rate your current state of 'fitness'?

Fitness is a direct extension to how we emotionally and physically feel. It influences our foundation of health in so many ways, and when we move with purpose in exercise we actively reinforce our foundation so we can move well and feel our best as we age.
 
How will you feel once you've moved your 'fitness' rating closer to '10'?

 
How would you rate your current state of 'spirituality'?

When we refer to 'spirituality' we are talking about your place in the world today. We all, at one time or another, ask the question, 'Why am I here?' And for some of us, we may have had an answer at one time or another, but simply lost focus as life got busy. Living a life of purpose in line with what makes us happy is something we can all do - that is if we want to. Where would you say you are right now?
 
How will you feel once you've moved your 'spirituality' rating closer to '10'?

 
Goal setting, purpose, vision, and finding direction in your life by design...

We are personally big believers in having goals in life. But discovering internal motivations and then sustaining them tends to be where most of the disconnect occurs.
 
Do you see value in goal setting? *

     
 
Is losing (aka releasing) weight one of your goals?

     
 
How much weight do you want to lose?

 
Please tell us more... How long have you been this weight? What have you tried to do about it? How does being this weight affect you physically, mentally and emotionally?

 
What is the number 1 goal you would like to achieve in the next 6 months and why?

What will achieving this goal do for you physically, mentally and emotionally?
 
Let's dig a little deeper into Nutrition...

 
How would you rate your nutrition knowledge? *

 
Are you interested in nutrition specific to improving energy, reducing inflammation, and enhancing overall health and well-being? *

     
 
Is there anything you find confusing and/or difficult about following nutritional advice?

     
 
Gotcha, we totally get that too. What specifically jumps out at you?

What are your top 2 or 3 biggest concerns with following nutrition advice?
 
Are you currently following a diet, meal plan or nutrition guide and if so, please provide details?

E.g. low carb, paleo, keto, etc
 
Now it's time to dig into 'Fitness'... how do you move with purpose?

 
How would you rate your 'Fitness' knowledge?

 
How many hours of your week are dedicated to fitness?

 
Are you currently following a specific training program, please provide details?

E.g. CrossFit program, Strength and Conditioning program, Working with a PT, Couch to 5k, etc.
 
What challenges, if any, do you find in maintaining a fitness program?

 
Let's talk about Coaching, Mentoring, and 'YOU'

The Live Your Manifesto program includes a number of tools and resources. But as good as tools and resources are, there's a huge element of choice involved in their implementation.

The following questions will help us better understand your current motivations that drive your passions in life and help us determine whether our style of coaching and mentoring is a good fit for you.
 
Do you consider yourself a coachable person? *

     
 
Have you ever invested in a coaching or mentorship program?

     
 
Awesome! Was there anything you specifically appreciated or didn't appreciate about the experience?

Share any likes, dislikes, how the process made you feel, etc.
 
Which of the following qualities do you expect your coach and mentor to exhibit?


 
The Whole Life Manifesto Coaching Program is designed to provide on-going support, custom nutrition and fitness coaching, along with lifestyle mentorship and guidance.

Is leading a life you are truly proud of important to you?
*

     
 
Do you have the finances available to commit to a mentoring program? *


 
Is there anything at the moment that would stop you pursuing your health, fitness, mindset and lifestyle goals?

Thank you for applying for the Whole Life Manifesto Coaching Program.

Congratulations for taking action to move forward in life, and for stepping outside your comfort zone.

We will be reviewing your application and in touch shortly with details about the complimentary transformation call.

(And don't worry, we don't bite. Chat soon!) 

Yours in Health and Happiness,
Dai & Christie Manuel

PS - click the link below to join our FREE community on Facebook for ongoing support, workouts, and lifestyle coaching.
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Thank you for your interest in the 'Whole Life Manifesto' Coaching Program, but at this time we don't feel this program is the best fit for you.

If your circumstances change, please feel free to reapply or reach out to us directly with any questions.

In the meantime, we'd love to gift you digital copies of the Whole Life Fitness Manifesto & The Green Smoothie 7-Day Reboot. We know that if you take some time for yourself to read these and connect with the online WLFM Tribe, you'll notice some amazing shifts in your body, mind, and spirit. You'll be well on your way to optimizing health and happiness as well as creating your life by design. 

See you in the Tribe!

Yours in Health and Happiness,
Dai and Christie Manuel
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