Clone of Clone of Clone of Form

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Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Phone Number * This field is required.Mention your best phone number
Please enter a valid phone number.
4
How did you hear about us?
Please Select
Please Select
LinkedIn
Word Of Mouth
Social Media
5
How many contactable leads do you have for our team to start working on?* This field is required.Only count leads with valid, reachable phone numbers.
Please Select
Please Select
Less than 100 (ineligible)
100-200
200-300
300+
Starter/Growth requires 100-200. Scale requires 200+
6
Preferred Pricing Model* This field is required.
Please Select
Please Select
Weekly Basis
Plans (Starter Growth or Scale)
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Lead Types* This field is required.Best results: Leads under 90days old
Please Select
Pos
Plus (Referral Boost)
Unions
Will Kits
Response Cards
Credit Unions
Globe Life
All of the above
8
Active Days* This field is required.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Whole Week
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Starting Date and Time* This field is required.Only full-time availability (35+ hours/week) is eligible.
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First Appointment Time* This field is required.Only full-time availability (35+ hours/week) is eligible.
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AM
PM
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Last Appointment Time* This field is required.Only full-time availability (35+ hours/week) is eligible.
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Please indicate any exceptions to your availability.* This field is required.Full-time schedules of at least 40 hours/week are required.
Eg., personal commitments, appointments.
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Any additional details?
Huge
Large
Normal
Small
Ok
Ok
14
Which US states should we call in for you?* This field is required.Select all states you want us to call in for you (multiple selections allowed)
Please Select
All
None
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Lowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
15
Which CANADIAN provinces should we call in for you?Select all states you want us to call in for you (multiple selections allowed)
Please Select
All
None
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
16
What is your Local time-zone?* This field is required.
Please Select
Please Select
Atlantic Standard Time (AST)
Alaska Standard Time (AKST)
Central Standard Time (CST)
Eastern Standard Time (EST)
Hawaii-Aleutian Time (HST)
Mountain Standard Time (MST)
Pacific Standard Time (PST)
Other
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Please provide your Calendly link* This field is required.This is required to schedule appointments on your behalf
18
Provide your Zoom meeting details* This field is required.Please include the zoom link, direct zoom link, and passcode (if any)
Huge
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Ok
19
Secondary platforms for appointments* This field is required.Select all platforms you're comfortable using other besides Zoom
Please Select
Please Select
FaceTime
WhatsApp
Google duo / Meets
Phone call
None
20
How would you like us to handle missed appointments?* This field is required.
Please Select
Please Select
We contact the client within 24 hours to reschedule
Agent calls themselves
21
Please upload your ID Badge* This field is required.
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Max. file size: 10.6MB
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