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Miraclemind Client Intake Form

Coaching. Brainstorming, Masterminding Group with Amber Smith

After you've completed this form you will receive an email from Amber or her team about next steps.

Click the button below to start this form.

Start

Question 1 of 8

What's your full name?

Question 2 of 8

What's your email? (this is how my team will contact you with next steps)

Question 3 of 8

What is your Instagram handle or website?

Question 4 of 8

Why do you want to be a part of The Miraclemind? What do you hope to receive from the group? What do you plan to offer the group?

Question 5 of 8

What is your income goal for 2023?

Question 6 of 8

What does commitment personally mean to you?

Question 7 of 8

Is there anything else you want me to know?

Question 8 of 8

How will you be investing in The Miraclemind?

A

Pay in Full 6 Months ($6k)

B

Payment Plan 6 Months ($6 Monthly Payments of $1100)

C

Pay in Full 12 Months ($10k)

D

Payment Plan 12 Months (12 Monthly Payments of $1100)

Confirm and Submit