testing — joinchaselife.com

Name*
First Last
Email*
How did you hear about us?*
Skype Username*
Best Phone Number (including your dial code)*
What is the PRIMARY goal you would like Rachel & David to help you with?*
What Do You Feel Is The Reason(s) Why You Are Not Getting The Results You Want Right Now?*
I know that working with Rachel & David in Chase Life is by application only and there is a waiting list but this is why I think I would be a great fit to work with them:*
When are you looking to take action?*
- RIGHT NOW!
- Soon
- Some day...
Which of these statements describe you best right now (be honest!)?*
- An 'excuse maker' who looks for opportunity but finds 'reasons' not to take advantage of them
- A 'procrastinator' who wants to take action but never pulls the trigger until it's too late
- An 'action taker' who seizes opportunity and moves forward quickly