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10
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
What is your Instagram name?
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4
Phone Number
Please enter a valid phone number.
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5
What is your preferred method to hear about the opportunity?
Weekly Zoom Call
Private one-on-one call
Chat via text
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6
Does working from home interest you?
YES
NO
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7
How much additional income would you like to create each month?
$100-$400
$500-1,000
Full time income
Just for fun~ I don’t have a financial goal
Other
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8
How much time would you say you have to dedicate to working from your phone weekly/ daily? (You can measure this time by how long you spend on social media.)
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9
What are some qualities about yourself you would like me to know?
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10
Have you ever been a Preferred Member or Independent Distributor with Herbalife?
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