The Millionaire Club Application Form

Full Name

Email *

Phone

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Where did you discover Shamina?

Which of the following best describes you?

I have a business and I want to scale it

I have a business and I want to get it off the ground

I don’t have a business but I want to start one

I don’t have a business but I love money

What are your goals for this program?

What is your current monthly income and where do you desire to be?

What do you need help with the most in your right now?

Do you have a team?

Yes

I need help finding the right people

I don't need one right now

What are your current offers? (if none or don't have a business, please state this below)

What Makes Shamina The Best Mentor To Help You?