Please fill out the form below. This quick intake helps me tailor your 5-Day Cash Unlock Challenge. It takes about 3 minutes. Please answer honestly; there are no perfect answers, only your reality right now.

Your Information:

Full Name *

Email *

Phone (optional)

Job Title & Industry: *

Which best describes your current household? *

Married, no kids

Married, with kids

Single, no kids

Single, with kids

Other

Let's Get Real About Where You're At:

Which of these feels closest to your reality right now? *

Most months, I'm still living paycheck to paycheck

Sometimes, depending on the month

Not really, but I'd like more breathing room

When it comes to money, which statement feels most true for you? *

I make good money but never feel ahead

I've done well but want more control and confidence

I'm comfortable but not building wealth as fast as I'd like

I'm ready to turn my income into true freedom

What's most frustrating about your money situation right now? *

Your Money Snapshot:

What are your top 3 biggest monthly costs (rough estimate is fine)? *

Expense 1
Expense 2
Expense 3

If you had to guess, where does most of your extra cash disappear each month? *

Subscriptions/Apps

Dining out & delivery

Travel / Lifestyle Creep

Car/Insurance

Tech Gadgets / Phone

"Convenience" purchases (Amazon, etc.)

Other

Which financial goals matter most to you right now? (Select up to 3)

Select your primary financial goal(s)

Retirement Planning
Saving for a Home
Debt Reduction
Education Savings
Building Emergency Fund
Investing for Wealth Growth
Tax Planning
Achieving financial freedom / work optional lifestyle
Other (please specify)
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What would a clear win look like in the next 30 days? *

Can you commit 30 minutes a day for 5 days?

Yes, I'm in

I'll make it work

Not this week (Please follow up)

If I send a scheduling link, will you book within 24 hours? *

Absolutely

Probably, but please remind me

Not this round

Your preferred daily start time (Mon - Fri)? *

5-6p

6-7p

7-8p

8-9p

Anything I should know to tailor your challenge?

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