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Section 1: Personal Information

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First Name:

Last Name:

Email:

Cell Number

Section 2: Application Details

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How many years have you been in the business full-time?

What was your '24 - '25 Awards Year GDC?

Are you currently qualified for fee-based planning with NM?

How many staff partners do you have?

What do you most hope to get out of the program?

What would have to happen for you to feel like this was the greatest investment you've ever made for your business?

Step 3: Payment Information

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Name On Card:

Card Number

CVC

Address:

City:

Zip:

Country

Payment Plan Selection:

3 Monthly Payments of $4000

Payment Dates: Today, Oct. 15, and Nov. 15

One-Time Payment of $10,000

Payment Date: Today