Exit this survey We are not currently taking more members. TO GET ON THE WAITING LIST.. Please complete below. Thank you! The Habit Factor Accountability Group on Facebook (yes, you need to have a Facebook account to join ; ) Short Application Quickly help us understand how this accountability group will benefit you and what you will bring to the group Question Title * 1. Name Question Title * 2. Email Address Question Title * 3. What is your gender? Female Male Question Title * 4. Age? 55-65 45-55 35-45 25-35 Other (please specify) Question Title * 5. I heard about The Habit Factor via Amazon: Read The Book (kindle, paperback, hardcover) The "Habits 2 Goals" Podcast The App (Android, iOS Free or Paid) Friend ITunes The Pressure Paradox I downloaded the Free Tracking Template I am an AUTOBOT /crawler (an automated survey response machine) and you can and should DELETE this response!! Other (please specify) Question Title * 6. I will bring..... to the accountability group Question Title * 7. I'm hoping to gain... from the accountability group Question Title * 8. My goals with The Habit Factor include... Make Money Improve My Business Lose Weight Focus / Discipline Improve relationships Write a Book Run a Marathon I am an AUTOBOT /crawler (an automated survey response machine) and you can and should DELETE this response!! Other (please specify) Question Title * 9. Twitter Handle: Question Title * 10. I would like to join the group ASAP (as soon as possible) Next Month Next Year If FULL - Please put me on the waiting list Other (please specify) Question Title * 11. I am interested in small group coaching with Martin OR, a THF Certified Coach specifically for My Business Personal Growth If FULL - Please put me on the waiting list Other (please specify) Question Title * 12. I am currently using The Habit Factor app (ios or android) and tracking my habits Yes! Not yet. Plan to - still learning how to use and track I am tracking using The Habit Factor Free Template that I downloaded Question Title * 13. I agree to the following "RULES". I understand that not following them may result in the termination of my membership privileges. Please check ALL to demonstrate agreement/understanding. I will be an active and engaged participant! I will be a positive and encouraging participant! I will only share personal experiences and will not give advice to group members I will post my tracking charts weekly I understand that if I miss TWO weeks in a row I may be "escorted" out of the group ; ) . Yes! We want engaged, trackers! I understand this is not a substitute for personal coaching I recognize Martin or his associates may not always be able to address any/all questions but will do their best I accept that if I do not participate according to the above "rules" may be escorted out of the group. I know this is a volunteer/free group and also accept that it may cease at any time with or without notice. I am an AUTOBOT /crawler (an automated survey response machine) and you can and should DELETE this response!! Type your name/ signature here: Done