Please fill out this form with as many details as possible. Lack of details will result in an incomplete training program.
Fill out this form for a free sample training program!
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indicates required fields
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Define the/your goal. You MUST be specific:
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How will you benefit from reaching your goal?:
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Target Date or timeframe (for goal):
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How much time do you have to train?:
Extremely limited (less than 2 hours per week)
Limited (less than 4 hours per week)
Adequate (more than 5 hours per week)
As much as necessary to meet the goal.
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Do you have adequate resources (ammo, gear, etc.):
Yes
No
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If limited, list the items that will limit you.:
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Is an instructor or reference materials available?:
Yes
No
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Rate your level of desire to meet your goal:
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Name:
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Email address:
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Format you would like your program.:
Word
PDF
Mail ($10.00 shipping and handling)
Other (email me your request)
Are you interested in coaching?:
Yes
No
Phone (If yes to above):
USPSA or IDPA Number:
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Rate your skill: Accuracy:
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Rate your skill: Speed:
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Rate your skill: Weapon Manipulation:
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Rate your skill: Movement:
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Rate your skill: Match Tactics:
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Give me an overall statement about your ability.:
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