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1. Have you ever participated in an advanced training or coaching program with Robert Allen?
Select Your Answer Below
Yes
No
2. If you selected yes, please specify the training program(s).
3. 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
4. Given the right mentor, team, systems and tools, do you believe that you could become financially free?
Select Your Answer Below
No
Yes
5. According to your values, do you believe that it is okay for you to become financially free?
Select Your Answer Below
No
Yes
6. Which of the following listed below are forms of leverage? Check all that apply.
Other People's Money
Other People's Experience
Other People's Time
Other People's Ideas
Other People's Work
On My Own
7. 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 Your Answer Below
I would wait until my credit improved
Find a partner and use their good credit
I don't know
8. 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 Your Answer Below
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 not do it.
9. What is your current employment status?
Select Your Answer Below
Employed
Unemployed
10. How much have you set aside for retirement?
Select Your Answer Below
Less than $10,000
$10,000 - $20,000
$20,000 - $50,000
$50,000 - $100,000
$100,000 or More
NONE
11. How much do you have in savings?
Select Your Answer Below
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
12. Do you own or rent your current place of residence?
Select Your Answer Below
I own my Residence
I am Renting
13. How would you rank your credit?
Select Your Answer Below
Excellent
Good
Fair
Poor
14. Do you own a credit card?
Select Your Answer Below
Yes
No
15. Are your credit cards maxed out?
Select Your Answer Below
Yes
No
16. Briefly explain your current financial situation.
17. Which area most interests you?
Select Your Answer Below
Real Estate
Stock Market
Business and Marketing
Internet Marketing
18. What is your annual financial goal?
Select Your Answer Below
$100,000 - $200,000
$200,000-$500,000
$500,000-$1,000,000
$1,000,000 or More
19. When do you want to achieve this goal?
Select Your Answer Below
00 - 03 Months
03 - 06 Months
06 - 12 Months
12 - 24 Months
24 - 36 Months
36 - 48 Months
48 - 60 Months
20. Explain why it is important to achieve your financial goals.
21. Do you understand that in order for your income to change you must change? (i.e. your attitudes, perceptions and habits)
Select Your Answer Below
Yes
No
22. Do you consider yourself to be a committed person?
Select Your Answer Below
Yes
No
Trying
23. Are you willing/able to invest 5-10 hours of your time each week towards becoming one of Robert's student success stories?
Select Your Answer Below
Yes
No
Consult me
24. Will you do the assignments your mentors ask you to do?
Select Your Answer Below
Yes
No
25. Explain why you think you should be considered for Robert's student success story challenge?
26. Do you currently tithe/donate at least 10% of your monthly income to some sort of charity, church or community cause?
Select Your Answer Below
Yes, I do give back at least 10%
No, I do not give back at least 10%
27. Will you commit to tithe/donate at least 10% of your monthly income to some sort of charity, church or community cause?
Select Your Answer Below
Yes, I will give back at least 10%
No, I will not give back at least 10%
28. Once you have achieved your goals, how will you give back?
29. Yes, Robert Allen has my permission to use me as a testimonial.
30. Yes, I am willing to make a financial investment for this opportunity to work with Robert G. Allen.
31. Question or comment for Robert Allen and his selection committee.