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Name

First Name

Last Name

Phone Number

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What is your highest vision for you life?

What is the biggest challenge you are currently facing in your life right now?

In what ways is this challenge specifically affecting you emotionally? In what ways is this affecting you spiritually and in what ways it is affecting you financially? *

How committed are you to transforming yourself and taking 100% responsibility for becoming the highest vision you have for your life to cause the effects you truly want to experience emotionally, spiritually and financially??