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Have you ever participated in an advanced training or coaching program with Robert Allen?
Select
Yes
No
If you selected yes, please specify the training program below.
Which of the following Robert Allen Books have you read.
Nothing Down for the 90’s
Creating Wealth
Multiple Streams of Income
Multiple Streams of Internet Income
The One Minute Millionaire
None
Do you have a Millionaire Mindset
“To Fly As Fast As Thought, To Be Anywhere There Is, You Must First Begin By Knowing That You Have Already Arrived.” By Richard Bach
Given the right mentor, team, systems and tools, do you believe that you could become financially free?
Select
No
Yes
According to your values, do you believe that it is okay for you to become financially free?
Select
No
Yes
Which of the following listed below are forms of leverage? Check all that apply.
Opm: Other People’s Money
Ope: Other People’s Experience
Opt: Other People’s Time
Opi: Other People’s Ideas
Opw: Other People’s Work
Omo: On My Own
Scenario: Pretend that you found a real estate deal that would generate $5,000 in positive monthly cashflow and all you had to do is qualify for the loan. But, because of a bad bankruptcy, your credit is in the tank. What would you do?
Select
I would wait until my credit improved
Find a partner and use their good credit
I don’t know
Scenario: If you came
across a Real Estate deal that would put $25,000 dollars in
your pocket and all you had to do was come up with $5,000
how would you do it?
Select
Borrow from friend/family.
Borrow it from a credit card.
Borrow from savings/checking.
Borrow against car.
Borrow against home.
Sell my assets.
I could no do it.
Your Current Financial Situation
A good doctor always diagnosis his patient before he prescribes a remedy. Likewise, before we can even think about helping you, we need to know where you’re at financially. Take a few moments to explain your current financial situation below.
What is your current employment status?
Select
Employed
Unemployed
How much have you set aside for retirement?
Select
Less than $10,000
$10,000 – $20,000
$20,000-$50,000
$50,000-$100,000
$100,000 or More
NONE
How much do you have in savings?
Select
Less than $1,000
$1,000 – $2,000
$2,000 – $3,000
$3,000 – $4,000
$4,000 – $5,000
$5,000 – $10,000
$10,000 – $20,000
More than $20,000
Do you own or rent your current place of residence?
Select
I own my Residence
I am Renting
How would you rank your credit history?
Select
Excellent
Good
Fair
Poor
Do you own a credit card?
Select
Yes
No
Are your credit cards maxed out?
Select
Yes
No
Please
explain your current financial situation.
Your Financial Goals
“Everyone thinks that the principal thing to the tree is the fruit, but in point of fact the principal thing to it is the seed.” Friedrich Wilhelm Nietzsche.
Thoughts are like seeds. You are the fruit of the thoughts you have planted and nourished. As surely as the acorn becomes the oak tree, the images in your mind become your reality. Imagine yourself in conversation a few years from now. Try these words on for size: “I made my millions in real estate.” “I made my millions by investing in the stock market.” “I made my millions in business and marketing.” “I made my millions on the Internet.” Which one seems right to you?
Select
Real Estate Millionaire
Stock Market Millionaire
Business and Marketing Millionaire
Internet Marketing Millionaire
What is your annual financial goal?
Select
$100,000 – $200,000
$200,000-$500,000
$500,000-$1,000,000
$1,000,000 or More
When do you want to achieve this goal?
Select
00 – 03 Months
03 – 06 Months
06 – 12 Months
12 – 24 Months
24 – 36 Months
36 – 48 Months
48 – 60 Months
Why is it important to achieve your financial goals?
How Committed Are You
“Take the first step in faith. You don’t have to see the whole staircase. Just take the first step.” Martin Luther King Jr.
Do you understand that in order for your income to change you must change? (i.e. you attitudes, perceptions and habits)
Select
Yes
No
Do you consider
yourself to be a committed person?
Select
Yes
No
Trying
Are you willing
to invest 5-10 hours of your time each week towards becoming an Enlightened Millionaire Success Story?
Select
Yes
No
Consult me
Will you
do the assignments your mentors ask you to do?
Select
Yes
No
Why do you think you should you be considered for the One Minute
Millionaire Challenge?
Will You Be an Enlightened Millionaire
“Out of abundance He took abundance and still abundance remained.” The Upanishads
Do you currently give at least 10% of your monthly income back? (i.e. to a church, charity, cause or community organization)
Select
Yes, I do give back at least 10%
No, I do not give back at least 10%
Will you commit to give at least 10% back? (i.e. to a church, charity, cause or community organization)
Select
Yes, I will give back at least 10%
No, I will not give back at least 10%
Once you
have achieved your financial goals, how will you give back to
your community?
Enlightened Millionaire Success Stories
“Each one, reach one. Each one, teach one. Until all are taught.” By Mark Victor Hansen
Yes, Robert
Allen has my permission to use me as a testimonial. (i.e. T.V. Radio, Newspaper, Internet)
Yes, I am
willing to make a financial investment for this opportunity to work with
Robert Allen.
Do you have a Message for Robert?