HELLO CONTACT CENTER ORDER FORM
PATRIOT INSURANCE GROUP
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NAME: *
PHONE NUMBER: *
ORDER DATE: *
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EMAIL ADDRESS TO SEND PAYPAL (Vender will send you a PayPal link once order is received. Your order will be put in queue to work once payment is received). *
Type of Payment you will be using through Paypal *
START DATE ( Note: Orders will be worked in order they are received and after payment is collected through PayPal. HELLO works on Quality vs. Quantity and can take up to 30 days to complete an order. This can vary depending on how busy the call center is and the geographical area you provide to them): *
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AGENT NAME FOR SCRIPT: *
AGENT GENDER: *
EMAIL ADDRESS TO SEND LEADS: *
Leads are available in English and Spanish. Please choose below: *
PREFERRED DEMOGRAPHICS FOR CALL CENTER TO CALL (No ZIP codes are allowed). City(s), County(s), or State(s). Please list in order of preference if more than one area. If listing city(s) or county(s) please also specify the state they are located in. *
Name of City(s) *
Name of County(s) *
Name of States(s) *
NUMBER OF LEADS (MINIMUM ORDER 20): *
TOTAL COST ($11.00 each): *
LEAD EXPLANATION AND TERMS OF AGREEMENT
Once an order is received, it can begin running in 1-7 business days based on whether they have the area code registered with the Federal do not call  and also whether they have a current list of targets in that area. If they do not, they will acquire one. Note it can take several days to get enough names to fill a large order.

Not all lead orders can be filled in one call session. While many are, some areas are more difficult than others and can run out of targets before they are finished. When you do not have all of your leads, please email patriotinsurancegroup@gmail.com and they will work to rebuild your order and finish you in a timely fashion. You are important to them and so are your reorders. If you find that the leads are not coming through as fast as you like, they appreciate the feedback. In some areas of the US, they are forced to charge more than other areas simply because it’s harder to get people to agree to allow you to contact them, or there are less English speaking targets or possibly less year round residents. Regardless of the factors, they want to help you and your practice and appreciate you reminding us if a lead is owed.

**Occasionally consumers will say that they only said this to get the marketer off the phone. They are recording both ends of the calls and you will receive the end in which they agree to allow you to call them. If a consumer tells you this after they agreed to allow you to call them there is no credit available. This is a standard occurrence when purchasing introductions of this kind. If you find it happening too much, you should check your own opening to be sure that it is appropriate for getting conversations started.

Any leads that you feel do not meet their criteria must be returned within 48 business hours to Patriot Insurance Group, Inc. (patriotinsurancegroup@gmail.com) for a review which will then be sent to HELLO Contact Center. All leads that do not meet the criteria will be replaced at their cost if returned within the appropriate time frame and to the correct e-­‐mail address. All sales are prepaid and final. This serves as a legal and binding document.

CHECK BELOW TO AGGREE TO TERMS *
Required
BY SENDING IN THIS LEAD ORDER YOU ACCEPT THE TERMS AND CONDITIONS OF THIS AGREEMENT *
E-SIGNATURE - PLEASE TYPE IN YOUR FULL NAME BELOW TO AGREE TO ABOVE TERMS *
ADDITIONAL NOTE OR MESSAGE:
TERMS AND CONDITIONS
*Terms and Conditions – by submitting this form you understand that the vendor will send you a PayPal invoice to the email address you provided on this form and the order will not be placed in the queue to be worked on until payment is rendered. Due to changing market conditions and your chosen counties/states, order fill times may vary.  Minimum order 20 leads.
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