ETM Credit Transformation Questionnaire

1
Name* This field is required.
First Name
Last Name
2
Your Best Email* This field is required.
example@example.com
3
Phone Number* This field is required. Cell Phone Preferred
Please enter a valid phone number.
4
What State Do You Live In?* This field is required.
5
Which best describes your primary source of income right now?* This field is required.
Employment (W-2)
Self-employed / Business owner
Gig / Freelance
Other
6
Approximate monthly income range:* This field is required.
Under $2,500
$2,500 – $5,000
$5,001 – $10,000
$10,001+
7
Current savings or emergency fund status:* This field is required.
None
Less than 1 month of expenses
1–3 months of expenses
3+ months of expenses
8
Credit score range (if known):* This field is required.You can go to www.CreditLadyMonitor.com to access your scores for $1.00 Today
Below 580
580–669
670–739
740+
Prefer Not To Say
9
In your own words, describe your top 3 financial goals for the next 12–24 months.* This field is required.
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10
What does “financial freedom” look like for you?* This field is required.
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11
Which areas interest you most? (check all that apply)* This field is required.
Creating active income streams
Building passive income
Business ownership
Real estate investing
Credit building & leveraging
12
On a scale of 1–10, how committed are you to making significant financial changes in the next year?* This field is required.
13
What resources (time, money, skills) are you willing to invest in yourself right now?* This field is required.
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14
Are you prepared to invest financially in coaching, education, or tools to reach your goals?* This field is required.
Yes, immediately
Yes, within 3 months
Not yet
Type option 4
15
What potential obstacles do you foresee (e.g., time, mindset, debt, support system)?* This field is required.
16
How do you currently track or manage your finances?* This field is required.
Budgeting app (Mint, YNAB, EveryDollar, etc.)
Spreadsheet (Excel, Google Sheets)
Paper budget / notebook / checkbook
Cash envelope system
Automated bank or credit card alerts/statements
I don’t actively track—just pay bills as they come
17
What motivates you to “live life unapologetically” and create multiple income streams?* This field is required.
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18
Because I receive quite a few applications weekly, tell me why you would be a great candidate to work with?* This field is required.
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19
How Did You Learn About Our Services* This field is required.If you came through a broker just put "OTHER"
Facebook
Instagram
Referred by Friend or Family Member
Postcard Mailer
Google Search
Email Message
Other
20
Signature* This field is required.By submitting, you acknowledge this form is for assessment only and agree to be contacted about next steps.
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