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Welcome and congratulations for taking action to change your financial future!

Simply fill out the questions below and we will be contacting you to set up an interview! You MUST leave your phone number and best time to call for us to get in touch with you!

We look forward to connecting with you!

To Your Success,

Andrew Murray and Marie Torres
902-472-2260

1. Please fill out the following information

Please fill out the following information Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

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2. Best Time To Call

Best Time To Call

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3. What is your primary interest in pursuing this business opportunity?

What is your primary interest in pursuing this business opportunity? Income (residual or additional)

Freedom (job dissatisfaction, being own boss)

Fulfillment (making a difference)

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4. How much income per month do you want to earn from your home based business?

How much income per month do you want to earn from your home based business?

5. How much time can you devote on a weekly basis to achieve your financial goals and realize your dreams?

How much time can you devote on a weekly basis to achieve your financial goals and realize your dreams? Spare time 5-10 hours per week

Part time 10-25 hours per week

Full time 25 hours or more

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6. How much money are you able to invest in your business each month to grow your business?

How much money are you able to invest in your business each month to grow your business? Less than $150

$150-300

$300-$500

$500 - $1000

More than $1000

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7. What do you think will be the greatest obstacle for you to overcome to achieve your financial goals and dreams?

What do you think will be the greatest obstacle for you to overcome to achieve your financial goals and dreams?

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8. Explain any prior experience in a home based business or network marketing?

Explain any prior experience in a home based business or network marketing?

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9. Please rate yourself on a scale of 1-10 in the following areas (1=low,10=high)

Please rate yourself on a scale of 1-10 in the following areas (1=low,10=high) Your ability to be coached?
Your amibition level?
Your belief in your ability to succeed?
Your belief in Network Marketing?

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Work With TheMarketingCouple.comExit this survey

1. Default Section

1. Please fill out the following information

*2. Best Time To Call

*3. What is your primary interest in pursuing this business opportunity?

*4. How much income per month do you want to earn from your home based business?

5. How much time can you devote on a weekly basis to achieve your financial goals and realize your dreams?

*6. How much money are you able to invest in your business each month to grow your business?

*7. What do you think will be the greatest obstacle for you to overcome to achieve your financial goals and dreams?

*8. Explain any prior experience in a home based business or network marketing?

*9. Please rate yourself on a scale of 1-10 in the following areas (1=low,10=high)