application-Student Bonus call 1

Complete and submit this form to schedule your Student Bonus Call for

The REAL Money Doctor's SHORT WINDOW RETIREMENT PLANNING program

Application-Student Bonus Call 1

Name *

First

Last *

Last

Email Address *

Phone Number *

Primary

Alt. Phone

Secondary

Please Update the information below and answer all the questions so Dr Fred knows how best to help you on the call in your personal situation..

Mailing Address *

Mailing Address

Street Address

Apartment/Building/Suite #

City

State/Province

Zip/Postal

Country

1. Detail What you liked best about the program and how it has helped you: *

Be specific about what you liked and how it helped you

2. 1. Detail What you think needs some improvement in the program that would have helped you learn easier or faster: *

Be specific about what you would have liked to have seen in the program and or improvements that would have helped you

3. What specific questions do you have for Dr Fred on the call? *

The more specific the question, the easier it is to get the specific help you need

4. Please list any other thoughts you'd like to share:

Let yoursel go free in this section. What do you think? What do you feel?

Dropdown Dropdown

If you will not be emailing a chart please tell us why you're not in question #3 above

If you are human, leave this field blank.

Click the Submit button to submit your application.

You will be taken to Dr Fred's personal calendar where you can schedule your call.

Dr Rouse will personally review your responses and discuss them with you on your scheduled call.

To get your chart(s) or other additional information you'd like Dr Fred to review; please email to Admin@DrRouseNow.com