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Full Name
Phone Number
Email Address
State of Residence
Upload Resume (PDF, DOCX, max 5 MB)
Do you currently hold a valid life insurance license?
Yes, active license
Yes, but expired/inactive
No, but willing to obtain
Have you ever worked in sales before?
Yes
No
Some experience
Which best describes your background:
Customer service
Sales
Business/entrepreneurship
Other (please specify below)
What is your 12-month income goal?
$50,000 - $75,000
$75,000 - $100,000
$100,000 - $150,000
$150,000+
If you could create a business that gave you freedom, what would be your #1 priority:
Time
Money
Impact
What’s your #1 financial goal right now?
Build wealth
Protect family
Pay off debt
Create legacy
Other (please specify below)
How many hours per week are you willing to dedicate to building your business?
10-20 hours (part-time)
20-30 hours
30-40 hours
40+ hours (full commitment)
What best describes your current situation?
Unemployed and ready to start immediately
Employed but looking for better opportunity
Self-employed wanting to expand
Just exploring options
How soon are you looking to start?
Immediately
Within 30 days
Just exploring
What motivates you most about this opportunity?
High income potential
Business ownership
Helping families
Personal freedom
All of the above
If this opportunity was like a sports team, where do you see yourself playing?
Star player – I want to lead and win big
Solid role player – I like contributing consistently
Up-and-coming rookie – I want to learn and grow
In 100 words or less, tell us why you believe you'd a good fit for Planright Financial:
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