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Registration Form

Client Registration Form

Name

*

Best Phone Number for clients to reach you

*

Email

*

How did you hear about us?

*

How did you hear about us?

A

Social Media

B

Word Of Mouth

C

Email

D

Refer

Reference

How many workable leads do you have for our team to call?

*

How many workable leads do you have for our team to call?

A

Less Than 100

B

100-150

C

150-200

D

200+

Service Level

*

Service Level

A

Trial

B

Bronze 4-5

C

Silver 8-10

D

Gold 16-20

E

Platnium

F

Starter 15$/hr

G

Growth 18$/hr

H

Scale 20$/hr

I

Custom

Lead Type

*

Lead Type

Field Days

*

Field Days

Any schedule exceptions

*

First Appt Time

*

Last Appt Time

*

Comments

What US states will you need us to call for?

*

What US states will you need us to call for?

What CAN provinces will you need us to call for?

*

What CAN provinces will you need us to call for?

What is your local timezone?

*

Calendly is required, Please provide your Link

*

Additional Back Up Presentation Platforms

*

Additional Back Up Presentation Platforms

A

Google Duo/Meet

B

Facetime

C

ID Badge

*

Size limit: 10 MB

How would you prefer we handle call backs for missed appointments/no shows?

*

How would you prefer we handle call backs for missed appointments/no shows?

A

Primesetters Calls Within 24 Hours To Re-schedule

B

Agents Calls Themselves