TUITION

Your First and Last Name*

Your best Email Address to reach you*

Best Contact Phone Number*

What is your Facebook Name*

Please tell us who referred you to our Rev Up program? Write their name or names below.

What is your biggest motivation to lose or gain weight/get healthy?

What are you looking to improve in your health and wellness?

How much weight do you want to lose or gain?*

What kinds of diets/food plans have you tried in the past?

If you are currently exercising, tell us what you do.

Do you currently take any Young Living nutritional supplements or other supplements regularly? If yes, please list those Young Living products.

Do you have an active Young Living Account? (Choose all that apply)

If yes, enter your Young Living account number. Note: If you have an Active Young Living Account, you will want to order your supplies through YOUR OWN ACCOUNT preferably through LOYALTY REWARDS to maximum your member benefits.

If you are a Brand Partner, who is listed on your Young Living Account as your Diamond support?*

THERE ARE THREE LEVELS OF PARTICIPATION (YOU get to choose YOUR level of participation)

Do you have your Good, Better, or Best selection

If you are part of the Starr Health organization or just opened a New Young Living Account and ordered your supplies throught the SUPPLY LIST link above. You are eligible for one month free tuition with your NingXia Red order. Click FREE TUITION below.

I understand once my application is recieved I may be asked to supply a copy of my receipt(s)

Any additional information I should know?

DISCLAMER #1 I agree that: By purchasing these products and participating in the Rev Up program, that Wendy Clayton and any leaders sharing this plan with you are not liable for any potential damages incurred. She is not a doctor or RD, the wellness program is simply meant to guide you to eat well. Any statements made have not been evaluated by the Food and Drug Administration and not meant to t*

DISCLAIMER #2 I agree that: This plan in its entirety, all guides, and journals as well as instructional videos are the intellectual property of Starr Health, LLC. Any sharing with outside parties, defined as any person not in the “Rev Up Wellness” Facebook Group, is prohibited without express written permission.*