Jay$ko Capital - Credit Survey

First Name *

Last Name *

Email *

Phone *

Date of birth *

If referral, who were you referred by?

Why do you want credit repair? *

Are you currently behind on any bills? *

Yes

No

Are you on a payment plan with any collection agencies? *

Yes

No

Be honest with us, why haven't you hit your credit goals yet? *

On a scale of 1-10, 10 being the highest, how serious are you about making a change? *

In order to reach your goal, how quickly does something need to change for you? *

Are you ready to invest in yourself TODAY? *

Yes, I am ready to invest and transform my life

No, I want life to stay the same

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HOW IT WORKS

STEP 1
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HOW IT WORKS

STEP 1 Fill out the form below

STEP 1
Fill out the form below