WWUMA Registration

upward mobility academy registration

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* Indicates required field

1. Name (First, Last): *

First

Last

2. Email: *

3. Phone Number: *

4. Address: *

Line 1

Line 2

City

State

Zip Code

Country

5. Marital status: *

6. Occupational status: *

7. If you're an entrepreneur (full or part time), tell us about your business: *

8. Have you ever attended one of LaTia's webinars or seminars before? *

8B. If yes, do you remember when and the topic? *

9. Are you ready to do the work to move forward, even if it requires leaving behind people, places, things and ideas that aren't consistent with your new process? *

10. What do you consider your greatest asset and deficit? *

11. Are you interested in ongoing entrepreneurial and personal development? *

12. What do you hope to get out of this 2-day seminar: *

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Upward Mobility academy

upward mobility academy registration

please complete