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Sales Lead machine survey form - Sales Leads Machine- Business locations for free listing

Age
Employment Status
Marital status*
Sex*
  1. Are you a homeowner?
  2. How do you own it?
  3. Do you have criticle illness protesction?
    1. Would you like a free review of your policy?
    2. When you like to protect your income with a free quote?
  4. Do you have a Morgage?
    1. When is it due for renewal?
  5. Do you have a Morgage protection?(A policy that will pay off the mortage on your death)
    1. Would you like a free review of your policy?
    2. When you like your family's future with a free quote?
  6. Do you have any life insurance
    1. Would you like a free review of your policy?
    2. When you like to protect your family with a free quote?
  7. Do you have a will?
    1. When was your will made?
    2. When you like to get peace of mind for your loved ones with a free Will consultation?
  8. Do you have Powers of Attorney in place?(a legel documents that helps trusted people manage your affairs if you are unable to)
    1. Which Power of Attorney do you have?
    2. When you would you like to ensure your affairs are managed by a trusted person if you are'nt able to, with a free consultation meeting?
  9. Who is your current gas & electricity supplier
      i.When is your contract due for renewal
  10. Do you run your own business
      i.What type of bussiness is it?
Thank you have now been entered into the survey Prize Draw Main Prize - HOLIDAY IN INDIAN
In order to enter the Prize draw we will need to contact you should you win. Please give us your contact details:
  1. Are you a homeowner?*
  2. How do you own it?
  3. Do you have a mortgage?*
  4. Do you have any life insurance? (a policy that will pay you a lump sum on your death)*
  5. Do you have a Will?*
  6. Do you have Powers of Attorney in place? (a legal documents that helps trusted people manage your affairs if you are unable to)*
  7. Do you run your own business?*
  8. Who is your current gas & electricity supplier?
  9. Do you have criticle illness protesction?
    1. Would you like a free review of your policy?
    2. When you like to protect your income with a free quote?
    1. When is it due for renewal?

In order to enter the Prize draw we will need to contact you should you win. Please give us your contact details:

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