Full Name *

Phone number *

Email address *

What’s your income goal within the next 6–12 months? *

What’s stopping you from hitting that goal right now? *

What is your credit score? *

What are you most interested in learning? *

Will anyone else be involved in the decision-making process? *

Do you currently have a business, Job or side hustle? If yes, what is it? *

What does hitting your first $100K mean to you personally? *

Why should we choose you to be part of the 100K Club? *

Have you ever invested in a mentorship before? *

Yes

No

If accepted, are you ready to invest in yourself right now? *

Yes, I have the funds ready

I can get access to funding/credit

I need a payment plan

Not ready to invest yet

What budget are you prepared to invest? *

Under $500

$500–$1,000

$1,000–$3,000

$5000

How soon are you looking to get started? *

ASAP

This week

Within 2 weeks

Just researching for now

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