Savage Presence Application Your Full Name Email Phone Describe your current state of mind in 5 sentences On a scale of 1(great) to 10(horrible) how do you feel right now Name 3 things you wish you could change about your significant other. What is your current level of physical activity? On a scale of 1(chaos) to 10(well oiled machine) rate the level of control that you feel you have in your life right now. Describe your perfect day in 1 paragraph or less. Do you own your own business or do you wish to someday? What is the biggest obstacle in your life that holds you back right this minute Who is the most important person in your life right now? On a scale of 1 to 10 rate your relationship with your significant other.