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CGE Pre-Call Qualifier Form
1
What Is Your Full Name?
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First Name
Last Name
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2
What's Your Best Email?
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example@example.com
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3
Where are you located?
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Afghanistan
Albania
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American Samoa
Andorra
Angola
Anguilla
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Argentina
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Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
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Belarus
Belgium
Belize
Benin
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Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
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Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
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Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
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Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
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Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
United States
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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4
What is your contact number?
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(If Outside of the US / Canada, please provide a WhatsApp Number with the Correct Country Code) (By submitting this form, you agree to receive transaction messages from Shane Hummus. Text and data rates may apply. Message frequency varies. Reply STOP to unsubscribe or HELP for help.)
Area Code (+1)
Phone Number
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5
Do you agree to receive transaction messages from us?
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Select YES or NO to proceed.
Please Select
YES
NO
YES
Please Select
YES
NO
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6
Leave a link to your Instagram handle, your Facebook page, or your Twitter handle, whichever one you use the most.
*
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7
utm_source
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8
utm_medium
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9
utm_campaign
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10
What does your YouTube channel currently look like?
*
This field is required.
I haven't started a YouTube channel yet
0-100 Subscribers
100-1,000 Subscribers
1,000-10,000 Subscribers
10,000-100,000 Subscribers
100,000+ Subscribers
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11
What do you do for an occupation right now?
*
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Example: Accountant, Nurse, Business Owner, Unemployed Etc.
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12
With the principles, strategies and systems we teach inside, we were able to help students like you to make their first $10k-30k/month or more. What monthly revenue goal would be both
REALISTIC
and a
BIG WIN
for you over the next 6-12 months?
*
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Example: $10,000/month
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13
What is your est. current OVERALL monthly income?
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Less than $1,000/month
$1,000 to $3,000/month
$3,000 to $5,000/month
$5k-$10k/month
$10k-$30k/month
$30k-$100k+/month
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14
What are your biggest challenges/obstacles right now that are keeping you from achieving your goal?
*
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Please be as detailed as possible so we can best understand your situation.
Huge
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Small
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15
If a trusted advisor on our team presented a suggestion that would help grow your YouTube channel to the goals you stated above, would you implement on it?
*
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Please Select
YES, no questions asked
YES if I understand it
No, I don't trust my business development to people who build successful 7 figure YouTube brands
Please Select
Please Select
YES, no questions asked
YES if I understand it
No, I don't trust my business development to people who build successful 7 figure YouTube brands
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16
How soon do you want to start growing your YouTube channel?
*
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Please Select
Yesterday
Right Away
Within The Next Few Weeks
Within A Few Months
Too Busy Right Now But Somewhere Down The Line
Please Select
Please Select
Yesterday
Right Away
Within The Next Few Weeks
Within A Few Months
Too Busy Right Now But Somewhere Down The Line
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17
We only work with students who have sufficient startup capital. A YouTube Personal Brand business requires capital for education, startup costs, and training. Do you currently have access to investment capital ranging anywhere from $1,000-$6,000 (USD)? (NOTE: This amount is based on hundreds of successful Students)
*
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Yes, I have the funds
I have access to the funds
No, I do not have the funds nor access to it
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