The Legacy House - Business Partnership & Opportunity Form
Interested in creating an additional stream of income while making an impact?
Complete this brief form to learn more about opportunities with The Legacy House Financial Services. Whether you’re looking for additional income, professional growth, or the opportunity to build your own financial services business, we’d love to connect with you.
Name
*
First Name
Last Name
Email
*
example@example.com
City & State
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you a US citizen?
*
Please Select
Yes
No
Do you have a felony?
*
Please Select
Yes
No
What interest you most about this opportunity?
*
Extra Stream of Income
Career change
Building my own business
Financial education
Helping families
Professional/personal growth
Just exploring my options
Are you currently employed?
*
Please Select
Full-time
Part-time
Self-employed
Not currently employed
How much additional income would you ideally like to earn per month?
*
$500-$1000
$1000-$2500
$2500-$5000
$5000+
How many hours per week could you realistically dedicate to building an additional income stream?
*
Less than 5 hours
5-10 hours
10-20 hours
20+ hours
Do you currently hold a Life Insurance license?
*
Please Select
Yes
No
What are you hoping to accomplish financially or professionally over the next 12 months?
*
How did you hear about The Legacy House of Financial Services?
*
Are you available for a brief zoom conversation to learn more about the opportunity?
*
Please Select
Yes
Not right now, but I'd like more information
*
By submitting this form, I confirm that the information provided is accurate and authorize The Legacy House Financial Services to contact me regarding financial services business and income opportunities. I understand that submitting this form does not guarantee employment, income, licensing, or acceptance into any opportunity, and that additional requirements may apply.
☐ I have read and agree to the acknowledgment above.
*
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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