Application Form - AHA Fasting Academy

Please fill out this form in its entirety.

The more descriptive your answers, the better 🙂

First Name

Last Name

Where are you currently in your wellness journey?

Where do you want to be in the next 90 days?

Let's say our program has everything you need and you were a perfect fit for us, how soon would you like to get started?

Are you a part of the AHA Community? If so, how long have you been in the community?

How did you hear about us?

How much are you currently generating on a monthly basis?

0 - $ 2000 $ 2000 - $ 5000 per month $ 5000 - $ 10 000+ per month

Do you own a business, or are you in a performance-based industry (e.g., an industry where what you earn is directly related to your output)?

Yes No

Are you open-minded to learning?

Yes No

Phone

And finally, what motivates you to get out of bed and live your life? If nothing, explain why