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* 1. What's your contact info?

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* 2. What's your occupation?

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* 3. Current Annual Income

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* 4. What are your goals for the next 6 - 12 months?

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* 5. What's the #1 thing that has you stuck right now from accomplishing those goals?

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* 6. What motivates you the most to work with Jessica at this time?

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* 7. If selected what's the best time for us to speak over the phone?

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