A Premier Health & Human Performance Center

Todd Durkin 3.5 Day Mentorship Program Application

January 26-29, 2017

San Diego, CA

“WOW Mentorship”

(Fitness Quest 10 & Coronado Marriott)

Thank you for your interest in the TD 3.5 Day Mentorship program. I am honored that you have taken the time to apply for this truly once-in-a-lifetime experience. Please take your time and fill out the following questions thoroughly and accurately as I will read any/all information that you send to me. Feel free to take as much space as you need to answer the questions completely. In addition, please supply any other information that you feel will be useful for us to look through (bio, resume, blogs, websites, professional pictures/headshots, etc.). I look forward to receiving your application. Please save this as a Word Document and email back to us: when complete.

  1. What is your name? D.O.B.
  1. Date of Application:
  1. Best Mailing Address:
  1. City:
  1. State:Zip Code: COUNTRY:
  1. Best Email:
  1. Best Phone Contact Numbers: Cell:
  1. What is your current job position and title?
  1. Do you have a website? If so, what is it?
  1. How did you hear about the 3.5 Day Mentorship or at what event did I meet you?
  1. Please give me the “CNN version” of your background and/or attach a bio and picture of yourself with this application (, ).
  1. What are your top 3-5 goals for the next 1-3 years?
  1. What are your top 3-5goals that you want to accomplish in your lifetime?
  1. What are your greatest challenges today from a business stand-point?
  1. What is the top reason why you want to complete my 3.5 Day Mentorship program? What do you specifically need to get out of the program?
  1. What types of social media are you currently using? Are you maximizing your online presence? Why or why not?
  1. Do you wish to share anything else about you or your business that may be important for us to get to know you?
  1. Are you applying with a “buddy?” If so, what is his/her name?
  1. Anything else you want to share, please feel free to do so in this space.

Social Media: We LOVE social media and all attendees to the 3.5 Day Mentorship will benefit from our SM (Twitter, FB, Instagram, YouTube, etc.) presence. Therefore, if you use social media, what are your handles for the following so that we can give you some love if you attend the Mentorship:

FACEBOOK:

INSTAGRAM:

TWITTER:

YOUTUBE Channel:

OTHER:

Please email your completed application to and .

And PLEASE put this in the Subject Line when you submit: TD Mentorship Application

Once again, if you have a resume, bio, and/or picture that you can send along with this application, it would be greatly appreciated.

If you have any questions or concerns, please call us at (858) 271-1171 and ask for Ryan Rogers. Thank you for your time and I look forward to reading your application and connecting with you real soon. Expect to hear from us within 7-business daysof your application being submitted to let you know of your status.

Todd Durkin 3.5 Day Live 3.5 Day Mentorship Investment

$1,497.00

$1,247.00 (Early Bird Special—through December 15th, 2016)

SPECIAL--50% Off 2nd Person Special (this is discounted off the regular $1,497.00 rate; This second person can be a spouse, trainer, employee, friend/colleague, etc. and allows you to split the costs)

There are limited spots available for this program.

All attendees will receive my 5 audio CD “TD Trainer Pak” as well as some other extraordinary “WOW” bonuses.

If you have any questions, we are here to help you. Please email both Ryan Rogers and myself and we will gladly assist.

Thank you so much and can’t wait to help create massive IMPACT& WOW in your business & life.

Much love.

Todd Durkin, MA, CSCS

Owner, Fitness Quest 10 & Todd Durkin Enterprises

2004 IDEA & 2005 ACE Personal Trainer of the Year

Lead Training Advisor, Under Armour

Author, The IMPACT! Body Plan& THE WOW BOOK!