Name:

Age:
Gender:

 Are you a:

___Student

___Employed

___Self Employed

 Monthly Allowance/Income:

__3,000-5,000

__6,000-7,000

__8,000-10,000

__More than 10,000

1. What training program are you enrolled in this gym?

List of training program:
2. How long have you been enrolled in this gym?
__less than 3 months
__3-6 months
__ 1 year
__more than a year
3. Do you follow a dietary program?
__Yes __No
4. If Yes:
List of meal plan
5. For those who answer “NO” in question #, Are you interested in meal plan?
__Yes __No
6. Who provided your nutritional assessment?
__Myself
__Trainer
7. What is your allocated budget in terms of fitness and health?
If student:
__1,000-2,000/month
__3,000-4,000/month
If Working:
__1,000-3,000/month
__4,000-5,000/month
8. What meal plan would you have preferred for a day?
__Lunch
__Snack
__Dinner
__Breakfast, Lunch and Dinner
9. Do you prefer:
__Delivery at your location
__Picking up in the store
10. How many times will you avail this meal plan?
__2-3 times/week
__6 times/week
Other specify: