Submit Your Success Story!

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First Name:*
Last Name:*
City:*
State:*
Email:*
Phone:
Occupation:
Age:
How did you hear about us?	Choose. . . Live Event Friend Radio/Television Search Engine Another Web Site Brochure Other
Date you started challenge:*	Month January February March April May June July August September October November December   2003 2004 2005 2006 2007
Story category:*	Choose Category Fears/Anxieties Exercise/Diet Related Meeting/Interacting with People Relationship/Dating Family Career Athletic Challenges Travel Adventures Taken Funny Experiences Out of the Ordinary Experiences Other
Enter your story here:* (1000 character max)
What lessons did you gain from your 3-day challenge?*