Opportunity Feedback & Referral Form
Thank you for meeting with us today!
We appreciate your time today. Our mission is to help people create additional income, flexibility, and growth opportunities.
Your feedback helps us improve, and if someone came to mind during our conversation, feel free to share them below.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Did today's interview help you better understand the opportunity?
*
yes
no
somewhat
What stood out most to you? (all that applies)
*
Extra Income
Flexibility
Work from home
Helping Families
Growth opportunities
All of the above
On a scale of 1- 10, how serious are you about improving your income right now? (1 being not serious at all; 10 being very serious)
*
If you chose not to make a change today, what would likely hold you back most?
*
Time
Fear of starting
Unsure if it's for me
Budget
Need more information
Who do you know that may appreciate hearing about flexible income options right now? (name and phone number)
Any others? (name and phone number)
Best way for us to follow up with you:
*
Text
Call
Email
Opportunity Specialist Name:
*
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: