The Six Figure Academy Application
Hi :) I'm happy you're here!

Please take a few minutes to complete this application so I can better understand your current situation and the kind of support you and your business need.

After you submit the application, I'll reach out with a link to schedule a 45 min call where we'll dive deeper into creating a plan that will address the challenges you explain below.

The more detail you share, the better recommendations I'll be able to make!

If by the end of our call I feel like any of my offers could help you, I'll share what they are and you can decide if you'd like to work together. If I can't help you, I'd be happy to refer you to a trusted specialist from my network who could.

Okay, let's get started!
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Website or Facebook link *
Your answer
How old are you? *
How long have you been licensed? *
Your answer
What field do you work in currently? *
Your answer
Do you have a downline of agents? *
If yes, how many agents are in your downline?
Your answer
Who is your current IMO/FMO? *
Your answer
Have you ever issued an annuity? If yes, how big was it? *
Your answer
Have you ever done a Medicare AEP or OEP? *
Your answer
What do you think you are missing/lacking in your current approach? (Example: Leads, Structure, Training, 1 on 1). Please go into detail. *
Your answer
What is the main reason you think you are struggling in this business? What are you looking for the most support in? *
Your answer
What is your biggest paid month doing life insurance? (ISSUE PAID, not SUBMIT numbers) *
Your answer
How much do you NEED to issue a month to pay your monthly household bills? *
Your answer
How much do you WANT to issue each month, consistently? *
Your answer
On a scale of 1-10, how badly do you want to make this business work so you can work from home, take more vacations, and spend more time with your family RIGHT NOW? *
Are you prepared to invest in support to solve these problems so you can finally have a steady flow of leads, appointments scheduled, and money flowing into your bank every month? *
Anything else you want me to know?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy