Wealthy Life By Design™ Clarity Consultation Application

You are in the right place if you know it's time for you to create a more robust and welcoming relationship with the Wealthy Life that's your BIRTHRIGHT!

Fill out the information below and know that everything is confidential. I will followup with you shortly - congratulations on taking this brave and bold step.

Email *

Let's....

Your Name (required) *

Phone Number (required) *

What's Your Vision/Dream/Goal/Calling? How and who are you inspired to help and why? *

What does a more Wealthy Life look like to you? *

Do you have Your Own Business? If So What's Your Business Name & Website?

Yearly Business Revenue or Salary if Employed *

Are you able to invest in yourself or your business to initiate working together? (required) *

Yes I can immediately do that.

Yes if you allow me to finance it over a year.

Yes and I'll need your assistance to figure in how to finance it.

No I won't do the work to finance my vision and answer the call - it's not good timing for me yet.

In addition to yourself, who else is involved in the decision making process? *

Are you willing to take suggestions, advice, coaching and make changes where necessary? *

Yes

Required

Complete the following sentence. I am a(n)... *

Action Taker - I see opportunity and know instinctively & instantly when its a great fit to move ahead

Procrastinator - I decide to move ahead, then I pull back when it's time to actually get things done

Risk Averse Person - I rarely if ever take action and find opportunities almost always pass me by

If someone referred you please indicate who or how you found your way to this form

What's Your TIME ZONE? *

We will be in touch with you to provide a scheduling link if we discern we have a spot for you in our calendar! Is there anything else you want to let us know?

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