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First Name *

Last Name *

Email *

Phone *

Where Are You Located? *

Do You Have Any Of The Following Negative Items On Your Report: Late Payments, Collections, Inquiries, Charge-Offs, Student Loans, Repossessions, Bankruptcies, or Judgements (WE GET THESE REMOVED!)? *

What Was Your Credit Score The Last Time You Checked It? *

How Soon Are You Able To Start Fixing Your Credit? *

Are You Able To Set Aside $75 Per Month For The Next 3 Months To Fix Your Credit? *

Can we count on you to SHOW UP for your appointment (Extra Discounts If You Do!)? *

YES, I will SHOW UP & RESPECT the appointment time

No, I will not show up

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