Client Information Form

Note: Please advise the client that if they do not have a working PC / Mac and an e-mail address, then the client will suffer a slower than usual entity set-up time.

Please advise the client that if they do not have high speed internet access that they will suffer a degraded video training experience.

Please complete and submit this form so that we can contact your client and begin the entity set up process.

Preferred First Name
Phone / Alternate Phone
Best Time to Call Client's Time Zone
Spouse or Partner's name

Membership Status?

First Entity
Second Entity [optional]
Strategist Payment type
Print Minute Book
Foreign Registration Explained

Address Line 1
Address Line 2
City State ZIP

Information relating to the Client's Business Activities
Use CTRL key to select multiple activities if needed.

Is the business licensed? YesNo
If yes, please provide description of the license
in which state?

Company Source

Source of Client Lead

Please help reduce spam by answering this question. P.S. the answer is 21.