Bitcoin Digital Money Membership Application

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Please fill this form out accurately and truthfully. If you have not watched entire webinar overview go back to watch it before proceeding. After you submit your application, we will review it within 3-5 business days and email you. Please make sure to keep an eye out for email from us. Thank you!

Your Personal Details

All information is confidential for purposes of screening you for membership.

Your Email Address (double check spelling) *

Skype username?

Telegram username?

Best Phone Number (Just in case we need to contact you by phone also include best times to reach you *

Your Referral's Name *

Your Referral's Email & Phone Number *

What country do you live in? *

What are some things that stood out for you in the webinar training you went through? *

What are your dreams and goals? *

What membership level are you interested in? *

Gold .055 Bitcoin | Financial Mentorship

Diamond .125 Bitcoin | Financial Mentorship | Co-investing opportunities

Platinum $25K USD/BTC | Financial Mentorship | Co-investing opportunities| Wealth Creation

What do you currently do for a living/for income? *

What is your current monthly income? *

$2500-$5000

$5000-$10,000

$10,000+ per month

Less than $2500

Zero income

What is your FICO credit score? *

800+

750-800

700-750

650-700

600-650

Below 600

Your experience in investing/trading bitcoin & cryptocurrency markets *

Novice

Intermediate Experience

Expert Experience

If you are selected for membership, are you prepared to invest in yourself right now to reach your financial goals? *

Yes

Complete the following sentence. I am _________ *

A Procrastinator: Slow to do things even though I know its in my best interest.

A Blamer: I feel like its everyone else fault why I'm at the income level I'm at.

A Warrior: I realize the time for me to take full control of my financial life is right now. I'm willing ready and able to make it happen. I'm so grateful to be in the right place at the right time during this crypto boom! Lets GO!!!!

As you can imagine, we get a ton of applications everyday. Why? Because everyone wants to be rich but very few are actually COMMITTED to the process. Why should we select you to be one of the people that we help? Why you over somebody else? *

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