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October 2018
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Which do you want most?
High Income Clients (Wealthy)
Lower Income Clients
Who’s your “Perfect Client” (check all that apply)
Executives & C-Level
Blue-Collar Workers
Business Owners
Entry-Level Positions (lower income)
Other
What is the (ballpark) salary of your ‘Perfect Client’?
Less than $100,000
$100,000 to $400,000
$400,000 to $1 Million
Over $1 MILLION per year
What’s your profession?
Real Estate
Financial Advisor
Insurance Broker/Agent
CPA/Accountant
How many New Clients can you handle monthly?
Full Name
First
Last
Email
Mobile Number
×
Which Referral Sources do you want?
National Referrals
Local Referrals
Both
What Referral Sources do you want? (check all that apply)
Wedding Planners
Board of the Chamber of Commerce
Attorneys (Divorce etc)
CPA/Accountants
Mortgage Brokers
Hair Stylists
Public Relations
Home Stagers
Event Planners
Bankers (Asset Managers)
Marketing Consultants
Business Consultants
Financial Advisors
Gym Owners
Moving Companies
Veterinarian Services
Medical Groups
Town Government and Officials
Local BNI Leaders
Interior Decorators
Builders/Architects
Other
Other Referral Sources
How many referrals can you handle monthly?
What’s your profession?
Real Estate
Financial Advisor
Insurance Broker/Agent
CPA/Accountant
Full Name
First
Last
Email
Mobile Number
×
Which do you want most?
High Income Clients (Wealthy)
Lower Income Clients
Who’s your “Perfect Client” (check all that apply)
Executives & C-Level
Blue-Collar Workers
Business Owners
Entry-Level Positions (lower income)
Other
What is the (ballpark) salary of your ‘Perfect Client’?
Less than $100,000
$100,000 to $400,000
$400,000 to $1 Million
Over $1 MILLION per year
What’s your profession?
Real Estate
Financial Advisor
Insurance Broker/Agent
CPA/Accountant
How many New Clients can you handle monthly?
Which best describes your current lead generation?
I receive LESS than 5 leads weekly
I receive 5 leads or MORE weekly
Full Name
Email
Mobile Number
×
Are you accepting New Clients right now?
Yes
No
Select Industry
Real Estate
Financial Services
Insurance
Coach/Consultant
Enter Zip Code (or Market)
FULL NAME
*
Email
*
Mobile Number
×
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