First Name
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Last Name
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Email
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Phone
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I NEED MOST HELP WITH...
What do you need help with the most? Select from the dropdown.
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What do you need help with the most? Select from the dropdown.
Income: Increasing Cash Flow
Budgeting: Managing Money
Saving: Short Term & Investing
Debt Management
Asset Protection: Insurance & Will/Estate Planning
Mindset
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Have you done a coaching program or course before?
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Yes
No
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If Yes, what was the price? If No, enter N/A
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What's your greatest struggle in your finances?
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What's your greatest strength?
Why should we accept you into this program?
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What would you like to accomplish financially over the next 12 months?
How much are you ready, willing and able to invest to hit your goal?
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What do you need help with the most? Select from the dropdown.
Nothing
$500-$999
$1,000-$2,999
$3,000-$6,999
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FUNDING ...
What is your Annual Income?
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Less than 50K
50K-100K
100K-150K
150K and above
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What is your credit score range?
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Below 620
620-650
650-700
700 and above
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Are you interested in financing options?
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Yes
No
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