First Name *

Last Name *

WhatsApp No *

Whats App no for Communication

Email *

Actual Date of Birth

Provide Actual Date of Birth not the certificate one (in case if both are different)

Whenever I try to Set High Targets, I feel -- *

Uncomfortable/Fear/Negative

Comfortable/Confident/Positive

Select one option

Whenever I don't achieve my targets, I feel... *

Stressed/Sad/Insecured/Negative

Grateful/Relaxed/Faith/Positive

Select one option

Did your parents or family often say things like 'money doesn't grow on trees' or 'we can't afford it'? *

Yes

No

When I have to talk about Money with Family & Friends I feel… *

Select one

When I am not able to buy something expensive, I feel… *

I feel Compromise/Not Good enough/Negative

I feel Grateful/Good Enough/Positive

Select one

When you think about business, do you think its difficult or there are chances you might fail? *

Yes

No

When I have to ask for Money, I feel… *

Ashamed/Angry/Uncomfortable/Negative

Responsible/Relaxed/Comfortable/Positive

When I see my competitors making more, I feel… *

Happy/Inspired/Positive

Jealous/Desperate/Negative

Making Money is Difficult for Me *

Yes

No

Creating Wealth is very Difficult for Me *

Yes

No

Select any one

Making Money has always been a Struggle for me *

Yes

No

Select One of them

There is too much Hard Work Required to Make Wealth *

Yes Definitely

Not Really

Select any one

Making too much money will make me less Spiritual *

Creating Big Money Goals is being too Greedy *

Making Big Money is not important in life *

Yes

No

I am not good at Money Management *

Yes

No

Focusing on Making Money Means less time to Live Life Fully.. *

Do you believe rich people are greedy or bad? *

Yes

No

I am Lazy, I Generally avoid working (I Procrastinate) *

Do you find it hard to charge high for your service/ business / products? *

Yes

No

I don't like taking Risk... *

Yes

No

I have tried everything, I am not able to increase my income *

Yes

No

I do my Best but Situations & People in my life don't support me to make money.. *

Yes

No

I Love getting things Free.. *

Yes

No

I can't take too much Risk... *

Are you making Double Income Compared to your Monthly Expenses? *

Yes

No

When you receive unexpected money, do you feel guilty or undeserving? *

Yes

No

Do you have Loans or Debts to pay? *

Yes

No

Are you Saving 10% of your Income every month? *

Yes

No

Are you regularly learning (from a coach, consultant or a mentor not just Youtube Videos)about how to invest and multiply your Income? *

Yes

No

Do you often feel like no matter how much you earn, it disappears quickly? *

Yes

No

Do you have a Clear Financial Freedom Plan based on your Lifestyle? *

Yes

No