check

June 2026 Cohort Intake Form

Welcome! This form helps me understand where you're starting from so I can support your transformation. Please use the SAME NAME & EMAIL you enrolled with - this allows us to track your progress and hold you accountable!

Click the button below to start.

Start

PERSONAL INFORMATION

.

Question 2 of 38

Full Name*

Question 3 of 38

Email* (use the same email you enrolled with)

Question 4 of 38

Phone Number*

Question 5 of 38

Age*

Question 6 of 38

Birthday*

Question 7 of 38

City, State, Country*

Question 8 of 38

Mailing Address* (we might want to send you something special 😉)

Street Address:
City:
State:
ZIP Code:
Country:

ABOUT YOUR LIFE

.

Question 10 of 38

What is your occupation?*

Question 11 of 38

What is your approximate annual household income?*

A

Under $50K

B

$50K-$75K

C

$75K-$100K

D

$100K-$150K

E

$150K-$200K

F

$200K+

Question 12 of 38

Tell us about your family* (marital status, number of kids, who lives in your household)

Question 13 of 38

What is your "Why?" - Why did you join this program? Dig deep! What do you hope to change or create for yourself and your family?*

GET TO KNOW YOU (FOR OUR KICKOFF CALL!)

.

Question 15 of 38

Share something interesting or unique about yourself that you'd like the rest of the cohort to know!*
This could be: a hobby you love, a fun fact about your background, something you're passionate about, a hidden talent, or anything that makes you YOU! We'll use this to introduce everyone at our kickoff call 😊

Question 16 of 38

What are you most excited to learn and transform in this program?*

YOUR FINANCIAL STARTING POINT

.

Question 18 of 38

Do you currently have any investments?*

A

Yes

B

No

Question 19 of 38

If yes, what type?

(Select all that apply)
A

401(k) or 403(b)

B

Traditional IRA

C

Roth IRA

D

Brokerage account

E

Real estate

F

Other: _____

Question 20 of 38

If yes, what is the approximate total value of all your investments?

A

Less than $10K

B

$10K-$25K

C

$25K-$50K

D

$50K-$100K

E

$100K+

F

I don't know

Question 21 of 38

How much do you have in emergency savings right now?*

A

$0

B

Less than $1,000

C

$1,000-$5,000

D

$5,000-$10,000

E

$10,000+

F

I don't know

Question 22 of 38

What is your current net worth (approximately)?*

A

I don't know

B

Negative (in debt)

C

$0-$25K

D

$25K-$75K

E

$75K-$150K

F

$150K+

Question 23 of 38

On a scale of 1-10, how confident do you feel about halal investing right now?*

A

1 - Not confident at all

B

2

C

3

D

4

E

5 - Somewhat confident

F

6

G

7

H

8

I

9

J

10 - Very confident

YOUR GOALS & ROADBLOCKS

.

Question 25 of 38

What are your three biggest financial goals for the next 12 months?*

Question 26 of 38

What are your biggest roadblocks when it comes to building wealth?*

(Select all that apply)
A

Don't know if investing is actually halal

B

Don't know where to start

C

Don't have enough money saved yet

D

Too busy with work/family

E

Afraid of making mistakes

F

My spouse handles the finances

G

Don't understand investing

H

Overwhelmed by too much information

I

Cultural shame around discussing money

J

Other: _____

Question 27 of 38

What would make you feel like this program was the best investment you've ever made? Paint the picture - what does success look like for you?*

HOW YOU FOUND US & WHY YOU SAID YES

.

Question 29 of 38

How did you first hear about LushedUp Finance?*

A

Instagram

B

The webinar

C

Friend/family referral

D

Facebook

E

YouTube

F

Tiktok

G

Others: ________

Question 30 of 38

If you were referred by a friend or family member, who referred you?

Question 31 of 38

What made you decide to join this program? What about the webinar, the messaging, or Hamna herself made you say YES? Be specific - this helps me serve you better!*

Question 32 of 38

What almost stopped you from joining? What hesitations or doubts did you have before enrolling?*

ADDITIONAL SUPPORT

.

Question 34 of 38

Is there anything else you'd like me to know about your financial situation, your goals, or what you need support with?

PERMISSIONS & ACCOUNTABILITY

.

Question 36 of 38

May we use your feedback and transformation as a testimonial?*

A

Yes

B

No

C

Ask me later

Question 37 of 38

If yes, how would you prefer to be identified?

A

Full name and photo

B

First name and photo

C

First name only, no photo

D

Anonymous (initial or pseudonym)

Question 38 of 38

May we share specific financial results in your testimonial (like "invested $X" or "grew net worth by $X")?*

A

Yes

B

No

C

Ask me later

Confirm and Submit