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  5. Welcome to your WEALTH JOURNEY.
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Contact Information
First Name : 
Last Name : 
Phone : 
Email Address : 
 
 
 
FAMILY MEMBERS & Ages
   
 
 
 
When do you want new information? Pick one.
 
NOW
 
Next Month
 
Don’t Know
 
 
 
What information are you looking for? Check all that apply.
 
Savings
 
Investing
 
Passive Income
 
Residual Income
 
Other

 
 
 
Who will use the information? Check all that apply.
 
Me
 
My Family
 
Others

 
 
 
Why do you want more information?
   
 
 
 
Income
 
To $100K
 
$100-$250k
 
$250-$500K
 
$500K +
 
 
 
Assets
 
To $1 million
 
$1-$5 million
 
$5-$10 million
 
$10 million +
 
 
 
Are you interested in working with a mentor or coach?
 
Yes
 
No
 
Maybe
 
 
 
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