Empowering Employees For Economic Excellence

1

Contact Name* This field is required.

First Name

Last Name

2

Best Email* This field is required.

example@example.com

3

Phone Number* This field is required. Cell Phone Preferred

Area Code

Phone Number

4

What are your goals?* This field is required.(Check all that apply)

Buy a new home

Buy a new car

Invest in multiple real estate properties

Start a new business

Grow an existing business

Financial Education For Smart Credit and Money Decisions

Build a legacy/Generational wealth

Other

5

Which Program Are You Choosing To Commit To?* This field is required.You are making a decision based on your present and future goals and your budget

PWAP $149 down/$77 monthly (save $50.00)

Premium $249 down/$149 monthly (save $50.00)

Premium $249 down/$185 monthly (save $50.00)

Express Program #1: $2,500 (one time payment) - (save $1,000.00)

Express Program #2: $1,000 (one time payment) - (save $500.00)

6

What Level Of Personal Commitment Are You At Today?* This field is required.This allows us to know who's serious about changing the course of their financial future and accomplishing their goals. Please Note: Pricing is subject to change. You are able to lock in special pricing to secure your position.

Ready to complete my registration today

I need a week

I need 2 weeks

I will put a $100 deposit down today to hold special pricing for 30 days

7

Is there anything else we should know about you and/or your goals?* This field is required.Put N/A if no

8

How Did You Learn About Us/Who Referred You?* This field is required.If you spoke with someone please include their name or if you discovered us online, please let us know which platform