Name *

First Name

Last Name

Phone *

(###)

###

####

Birthday *

MM

DD

YYYY

What is your approximate household income?

$40,000 or less

$40,000 to $60000

$60,000 to $80000

$80000 to $120,000

$120,000 +

What is your current relationship status? *

Single

Dating

Married

Divorced

Widowed

Please read carefully and check below to agree: *

This application will be read for the purpose of evaluating whether or a potential client is a good fit for us. Once we have determined that you are a match for us, we will reach out to schedule a 3o minute free consultation. If you are selected for a 30 minute consultation, we may record the call for purposes of evaluation of your potential as a client. No recording of these calls may be made without the consent of Good Vibe Strategies. Thank you so much for contacting us and know that we really appreciate you and your interest in working with us!

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