Appointment Request Form

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Full Name

First NameLast Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
What best describes your Situation:

Successful Business owner curious to hear about automated revenueConsidering Opening a Boutique/ Specialty Store, need helpStruggling for a while, Desperate for a Solution
Please describe in your own words what you are struggling with the most right now and how it is affecting your business and your life.
What do you want to achieve by working with us, what is your big outcome?
What is your desired amount of automated revenue that you desire to have starting in 90 days from enrolment in the system?
We are looking for businesses that are already successful. If you feel that you are successful, then so do we. Please describe your success in your own words ..
If what we have for you is EXACTLY what you feel will solve your biggest cash flow problem and stabilize your business, make it predictable and allow you to grow your business do you have the financial resources to invest in your success?

Yes, I have the money to invest in a solutionYes, I can access the money to invest in a solutionNo, I cannot invest in myself right now
Where are you on a scale of 1-10 ? (1 being I am not very serious about solving the problem and 10 being I seriously want to make this happen now)
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