Influencer Application

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone Number

Area Code

Phone Number

4

What is most important for you?

Pay off debt

Increase savings

Replace full-time job

Stop living paycheck-to-paycheck

5

Have you heard of ItWorks before?

YESNO

6

What scares you the most?

Losing money

Embarrassment

Not enough time

7

What amount of $$ would be helpful to you each month?

8

What is your current occupation?

9

Are you ready to grow personally and professionally?

YESNO