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Wealth Protection Screening Intake

This form is used by Champion Park Advisors solely to determine if it would make sense for one of our Wealth Architects to conduct a confidential Sovereign Wealth Assessment.

Let's get started 👇

What’s your company name?

What's your (first and last) Name?

What is your Title?

Email Address

Phone Number

What type of Businesses do you own?

Ownership

What is your annual business revenue?

How many employees do you have?

Approximate Net worth?

Briefly explain your Real estate holdings?

Explain what existing Trusts you have?

Explain what existing Estate Planning you have?

State of Business Formation

Primary Location(s)

Referred by: Sourcing Partner

Phone Number

Email

Acknowledgement

I give consent for a Champion Park Advisor to contact me by phone, email or SMS text messaging to perform a complimentary Sovereign Wealth Assessment.

Thank you!