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VIP Day Intake Form
Details:
- One 30-minute intake, one 3-hour intensive, one 30-minute follow-up
- 2 months of client portal access
- Investment: $1,650
Name
Email
Tell me more about you/your family! How many people will be involved in your budget?
Which best describe(s) you/the other stakeholders in your budget? (Select all that apply.)
Salaried employee
Self-Employed
Freelancer
Retired
Unemployed
Seeking employment
Age
Please provide an estimate of your annual gross income (include all income from all parties involved in your budget).
$20,000 - $40,000
$41,000 - $60,000
$61,000 - $80,000
$81,000 - $100,000
Above $100,000
Income is variable
If your income is variable, please select a reliable MINIMUM you anticipate to earn in a month:
$1,000 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $6,000
$6,001 - $8,000
Above $8,000
Which of the following are you most interested in discussing? Select all that apply.
Building my budget
Budget upkeep
Combining finances with my spouse or partner
Spending habits
Debt payoff
Saving
Investing
Taking your business full-time
Pivoting to tech
Major life event (growing your family, moving, starting a new job, etc.)
Other (please use comment area at the end to include more details)
Tell me about the best coaching experience you've had and what you loved about it. (If you've never received coaching, please list what you are looking for in your coaching experience.)
VIP Days are only offered on weekdays. Can your schedule accommodate this?
Yes
No
Is there anything else you'd like me to know?
Send
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