Trim 4 Lifestyle Education Directory Form – Trim 4 Life

Healthy, Wealthy & Wise Directory Survey

We look forward to connecting with you to share exciting opportunities to interact with Trim 4 Lifestyle Education. Thanks in advance!

Instructions: Please complete this brief survey, which should take between 3-5 minutes to complete. Please note that your individual responses will be for Trim 4 Lifestyle Education and will never be shared with other parties.

Name

First

Last

Cell Phone #

Hone Phone #

Home - Street Address

Home - City & State

Home - Zip Code

Preferred Method of Contact

Select Your Age Range

Enter Your Birthday (Month & Day Only)

Enter your Expertise or Profession (e.g., Dentist, Student)

Would you like for us to include your contact information

Yes

(e.g., name, phone number, and/or email) in the directory for other GuyMetro members to see it? Note: If "No": Thank you. We will only use the contact information you shared for internal use only. It won't appear in the directory.

Please list a few of your hobbies.

Trim Lifestyle Health Coach is on Facebook and would like to connect with you. Are you on social media?

If on social media, what is your name/handle on your Twitter, Facebook, and/or Instagram accounts?

We are also working on updating the Trim Lifestyle Education website. What would you like to see on it?

Recipes

Annual Events

Coupons

Other

If you are human, leave this field blank.

Healthy, Wealthy & Wise Directory Survey

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