Free Financial Consultation Opportunity - Financial & Immigration Services

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Privacy and Confidentiality

Your privacy is our top priority. This form/information gathered will be held in a secure and private environment. Feel free to answer all questions or ask questions, share insights, or discuss any topics you'd like. Our aim is to create a space for open and meaningful consultation and advice on financial education and protection of your money.

Personal Information

Name *

First

Last

Gender *

Marital Status *

Number of Children *

Date of Birth

Country of Birth *

Country of Residence (Which Country Do You Live) *

United States
Canada

YOU MUST EITHER BE IN THE UNITED STATES OR CANADA FOR FREE FINANCIAL EDUCATION CONSULTATION

How Many Years Have You Lived in the Country of Residence (USA or CANADA) *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number *

Email *

Confirm Email

Languages You Speak Fluently *

English
Kiswahili
French

Financial Information

Employment Status *

Employed
Self-Employed
Looking for a job right now
Retired
Full-Time Student

Do you have Social Security Number (SSN)? *

Annual Income Range *

Up to $25,000
$26,000 - $50,000
$51,000 - $75,000
$76,000 - $100,000
$101,000 - $150,000
Over $151,000

Do you currently have investments? [ ] Yes [ ] No *

If yes, please specify the types of investments (stocks, bonds, real estate, etc.): If no, write N/A on the description

Financial Goals and Education Needs

What areas of financial education are you most interested in? (Check all that apply) *

Budgeting and saving
Investing and portfolio management
Retirement planning
Passive Income (Getting Extra Income)
Tax free accounts (advantages)
Debt management
Business Solutions
College Fund for my children
Family Bank and Estate Planning
Other

How did you hear about EBM SCHOLARS and our FREE 1-on-1 Meeting? *

Instagram
YouTube (EBM SCHOLARS)
YouTube (EBM SWAHILI)
Facebook
EBM SCHOLARS Website
TikTok
X (formerly Twitter)
LinkedIn
Google Search
Referred by a friend or family member
Other

Is there any person(s) who you know in the USA, and think that will benefit from this free financial education consultation? If yes, write their names, and contact information (phone numbers and states they live). We will reach to them to schedule the free consultation with them. *

Additional Information

Please share any specific concerns or areas where you feel you need the most guidance

Supporting Documentation

File Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 20 files.

If you want to upload any document(s) be it in PDF or photo to help us evaluate your situation before we schedule a meeting with us.

CONSENT *

I consent to having this website store my submitted information so they can respond to my inquiry.

You're just one step away! Click "Submit" to successfully send your application. You will also be contacted for scheduling the meeting.

Be In Control Of Your Financial Future and Legacy

Empowering Families. Building Financial Futures

Get a 2-Hour Free Financial Literacy Consultation

YOU MUST RESIDE IN EITHER THE USA OR CANADA (REGARDLESS OF THE IMMIGRATION STATUS) TO FILL OUT THIS INTAKE FORM

Privacy and Confidentiality

Personal Information

Financial Information

Financial Goals and Education Needs

Supporting Documentation