HIFE College Planning Program Consultant Agreement

HIFE College Planning Program Family Referral Form

HIFE CPP Family Referral Agreement

The purpose of this form is to assist HIFE CPP Certified Consultants who have a Student/Family that might be interested in the College Planning Program and need help in getting that family enrolled.

The Heartland Institute will gather the information provided on this form and contact one of our Consultant Mentors in your area. This local Mentor will then assist you in completing the enrollment process.

Please complete the information below and click the submit button. Once the Heartland Institute receives the information on the form, you can expect to hear from the Mentor within 3 business days. Thanks!

Referring Consultant Information

Your First Name*

Your Last Name*

Your Address (Street)*

Suite/Apt #

City*

State/Province*

Zip/Postal Code*

E-Mail Address*

Your Phone Number (Best to Contact)*

Agent Code*

Student/Family Information

Parent 1 Full Name*

Parent 2 Full Name

Student Full Name*

Contact Phone Number*

Email Address*

Referral Agreement

I authorize HIFE and/or the Consultant Mentor to contact the above family to discuss the College Planning Program.
HIFE will provide this information to Consultant Mentor who has agreed to assist in the enrollment process.
If the above referenced family enrolls in the HIFE College Planning Program the commission will be split between the referring Consultant and the Mentor.
Any business or product sold to the above family will occur outside the scope of this agreement and is dependent on an agreement between the referring Consultant and Consultant Mentor.

By Clicking "Agree" below, I agree to all terms in above Referral Agreement. I also understand that by typing my name in the box below it acts as my signature and acceptance of the aforementioned agreements:*

Agree

Consultant"s Name:*

The Date this Agreement was entered into:*

Date