Client Enrollment — MyGoodFico

Client Enrollment Form

2800 Glades Circle, Suite 156
Weston, FL 33327

954-400-0488

Please complete all fields below. Your information is used to set up your credit repair account and prepare your documents. All data is encrypted and secure.

Personal information

First name *

Last name *

Date of birth *

SSN — last 4 digits *

Current address *

City *

State *

ZIP *

Phone *

Email *

Identity documents

Driver's license * Front side — JPG, PNG, or PDF

Choose file

Utility bill * Must show your name and current address

Choose file

Select your plan

Individual

Individual plan

^$84_/mo

Credit monitoring + dispute service for one person

Couples

Couples plan

^$159_/mo

Both partners covered — best value for two

Payment

Secure monthly billing Card details collected by Stripe — PCI compliant, never stored by MyGoodFico

Stripe

— Stripe secure card fields load here when embedded in GHL —