Business Partner Intake Form

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Area Code
Phone Number
3
Email* This field is required.
example@example.com
4
Where are you located?* This field is required.
5
What do you do for a living?* This field is required.
6
Would you have interest in any of the following services/benefits?* This field is required.
Credit Restoration
Dispute Letters Mailed For You
Will, Trust, & Power of Attorney
Secured Credit Card
Online Banking Services
RentReporters (Use Rent Payments To Increase Credit Score)
Budgeting/Debt Payoff Education
Smart Credit Monitoring App (View all scores: credit score, auto score, hiring index score, and insurance score
Merchant Services (Payment processing systems for your business)
Interactive Presentation Tool
Online Training & Marketing Tools
Entrepreneur Success Kit
Business Tax Accounting Software
Identity Theft Protection
White Label Partner Program
Credit/Collection Letter Lawsuits filed for you
Business Funding Program
Personal Loans
Business Credit Program
HOME Ownership Program
Travel Discounts and Perks
7
1. Why are you looking to start a business and/or earn additional income?* This field is required.
8
2. Are you willing to invest in yourself?* This field is required.
Yes or No
9
3. Are you looking to start a business that you can work full-time or part-time?* This field is required.
Full Time
Part Time
10
4. If you were to become a business owner on a part-time basis, approximately how much would you need to earn per month in order to make this worth your time?* This field is required.
$500 to $1,000
$1,000 to $1500
$1,500 to $2,000
$2,000 to $2,500
11
5. Approximately how many hours could you commit each week to develop that kind of income?* This field is required.
4 to 6
6 to 10
10 to 16
16 to 24
12
6. How many months would you work those kind of hours in order to develop that kind of income?* This field is required.
2 to 4
4 to 6
6 to 10
10 to 12
13
7. If I could show you how to develop an income of the amount you selected, working the hours per week that you are committed to, over the course of months that you chose, would you like to receive the information?* This field is required.
Yes
No
14
Who Referred You? * This field is required.
First Name
Last Name
15
Appointment* This field is required.
16
How would you like to be contacted?* This field is required.
Text Message
Phone Call
Facebook/Instagram Messenger
Zoom Meeting
17
Once you have completed our Business Partner Intake Form you will be redirected to a quick 5-minute video to watch. Once you are finished watching the video, text "Agent" to 913-485-4174 that you are finished so we can discuss the next steps.
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