Page 1 of 2

Acquira Partnership Application

Complete the application below. If it’s a good fit, Acquira will contact you to schedule a strategy call.

Business Information

Full Name

Company Name

Email Address

Phone Number

Website

Instagram or Facebook

Business Location

Business Details

What industry are you in?

How many employees does your company have?

How long have you been in business?

What services do you offer?

Growth

What is your biggest challenge when getting new customers?

Approximately how many leads do you receive each month?

What is your monthly revenue?

Have you worked with a marketing or lead generation company before?

A
B

What are you hoping to achieve in the next 90 days?

Investment

Are you prepared to invest in a client acquisition system if it’s the right fit?

A
B
C

Additional Information

Is there anything else you’d like us to know?