Dave’s Facebook Seminar Questionnaire Sandbox Dave’s Facebook Questionnaire Test Test questionnaire for normal facebook campaigns, Taxes Declassified, Retire For L.I.F.E, Your Federal Retirement, and Medicare Declassified Step 1 of 12 8% Event Remaining BalanceName:* First Last Please confirm the advisor’s name.What is your preferred title?*i.e. President & FounderWhat credentials, if any, would you like listed?i.e. CFP®, ChFC®, CLU®, CTS™, CEP®, RFC®, etc. Email:* Please confirm the advisor’s email address. This will be the email address we use for consumer facing advertisements.Phone Number:*Please confirm the advisor’s phone number. This will be the phone number we use for consumer facing advertisements.Company Name:*Please confirm the advisor’s company name.Website address (URL):*Webinar Packages Gold – $1,999 Platinum – $2,999 Your Federal Retirement Webinar Packages Gold – $2,999 Platinum – $3,999 Please choose your Webinar Package* Gold Platinum Please choose your event type.* Dinner Seminar Workshop Please choose your event package.* Silver Gold Platinum Please choose your event package.* Silver Gold Platinum Please choose your event type.* Dinner Seminar Workshop Please choose your Elite Series Package.* Starter Pro Ultimate Lead Management InformationDo you want lead notifications to be sent to any other email addresses?* Yes No By default, your leads are sent to your email address.Additional Email Address*Enter in the other email address(es) you would like leads sent to. Please separate multiple email addresses with a comma.Will you be the main point of contact for our confirmation calling team?* Yes No You will receive an introductory call and be in direct communication with this team. *If you would rather have another member of your team be the main point of contact, please select “No” and then provide their contact information. Please provide the main point of contact's information.*Please include name, email address and phone number. Topic InformationChoose your event topic* Retirement Income Planning Social Security Taxes & Retirement Women & Wealth Social Security & Taxes Estate Planning Alternate Topic If you choose an alternate topic, it will not be guaranteed.Choose your event topic* The No-Compromise Retirement Plan – targeting age 55+ The New Holistic Retirement – targeting age 55+ The New Rules of Retirement Savings – targeting age 45+ Rising Tax Risk in Retirement Legislative Risk Please enter your alternate topic*Please note: Alternate topics are not guaranteed per our best practices. Event InformationHow many dates are you registering for?* One Date Two Dates Three Dates For in-person events, if the venue can only hold a limited number of people and/or you are opting for a smaller seminar package, we highly recommend offering no more than two dates. We do not recommend hosting three dates for in-person events. Please consult your Marketing Account Manager before submitting the questionnaire if you have questions regarding your seminar plan.Please enter the target geographic area for your webinar campaign.i.e. a certain county, multiple counties, radius around a city, etc. If applicable, please enter any specific federal departments you would like to target.Do you have any special notes for your campaign?Make sure to add any comments you have for this event. Retire For L.I.F.E Event InformationHow many sessions are you registering for?* One Two Sessions may include more than one date. For example you may host two sessions that take place over two days each, totaling 4 dates.Will your session take place over one day or two days?* One Two Will your sessions take place over one day or two days?* One Two 1 One-Day Session, 1 Two-Day Session Which mailhouse do you want to use for your mailers?* MBI LeadJig Other Not Sure Select “Not Sure” if you want more information on the options available with our different mailhouse partners.What is the name of the mailhouse you will be using?*No worries! We can help you decide which mailhouse would be the best fit for your market! We’ll be in touch to discuss the details and options available to you.Session 1 First Date* MM slash DD slash YYYY Event Start Time (Session 1 First Date)* : Hours Minutes AM PM AM/PM Event End Time (Session 1 First Date)* : Hours Minutes AM PM AM/PM Session 1 Second Date* MM slash DD slash YYYY Event Start Time (Session 1 Second Date)* : Hours Minutes AM PM AM/PM Event End Time (Session 1 Second Date)* : Hours Minutes AM PM AM/PM Session 2 First Date* MM slash DD slash YYYY Event Start Time (Session 2 First Date)* : Hours Minutes AM PM AM/PM Event End Time (Session 2 First Date)* : Hours Minutes AM PM AM/PM Session 2 Second Date* MM slash DD slash YYYY Event Start Time (Session 2 Second Date)* : Hours Minutes AM PM AM/PM Event End Time (Session 2 Second Date)* : Hours Minutes AM PM AM/PM Will you be charging a fee to attend your course?* Yes No The default fee if charging is $19 for the course fee and materials.For registrants paying by check, whom should checks be made payable?*Would you like us to do confirmation calls?* Yes No Free courses will have a larger volume of registrations, so we are including confirmation calls at no additional charge. If you want to do the confirmation calls yourself, please select No. If yes, our confirmation team will reach out to you before your event for additional details.Where will you be hosting your sessions?*Venue Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please provide any specific directions if necessary.*This includes parking information, building name, room number, map, etc. It is very important that we can make it as easy as possible for the consumer to feel confident in attending. Webinar InformationFirst Date:* MM slash DD slash YYYY First Date Start Time* : Hours Minutes AM PM AM/PM First Date End Time* : Hours Minutes AM PM AM/PM Second Date:* MM slash DD slash YYYY Second Date Start Time* : Hours Minutes AM PM AM/PM Second Date End Time* : Hours Minutes AM PM AM/PM Third Date:* MM slash DD slash YYYY Third Date Start Time* : Hours Minutes AM PM AM/PM Third Date End Time* : Hours Minutes AM PM AM/PM If applicable, please state what offerings you will have to encourage people to schedule an appointment during the webinar.ie. Free Retirement Analysis, Social Security & Tax Analysis, Retirement Road Map, Free Book, Risk Assessment, etc.We need to collect some information from you for your Evergreen Webinar. We will need to know your credentials for EverWebinar and Calendly along with where we can find your pre-recorded webinar.Do you have a scheduling platform (i.e. Calendly) that you currently use?* Yes No Please provide your personalized URL to set appointments.*i.e. calendly.com/companynamePlease provide your username and password for your calendar platform.*Please provide your username and password for EverWebinar.*Please choose from the following options as to where we can locate your pre-recorded webinar.* I will send a file CreativeOne’s BigMarker Account Hosted on URL When did you host a webinar with our BigMarker account?*Please provide the date of the webinar you would like to use.Please provide the URL link of your pre-recorded webinar.* Venue InformationWhat is the name of the venue you will be hosting your events?*Do you have permission from the venue to use their imagery? For example, building photos, menu items, logo, etc.* Yes No This is an important piece of our marketing as local imagery typically performs best.Please reach out to the venue to see if it is ok if we use any of the imagery from their website and/or social media profiles.Venue Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please provide any specific directions for this venue if necessary.*This includes parking information, building name, room number, map, etc. It is very important that we can make it as easy as possible for the consumer to feel confident in attending.What is the total number of people the venue can hold?*What is the set menu for your dinner seminar?*Will you be hosting each event at the same venue?* Yes No We highly recommend having all your event dates at the same venue for better performance. By choosing another venue for this campaign, your seminar will not be guaranteed.Consent* I acknowledge that by choosing another venue, my seminar will not be guaranteed.We highly recommend having all your event dates at the same venue for better performance. By choosing another venue for this campaign, your seminar will not be guaranteed.What is the name of the second venue you will be hosting your events?*Second Venue Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please provide any specific directions for the second venue if necessary.*This includes parking information, building name, room number, map, etc. It is very important that we can make it as easy as possible for the consumer to feel confident in attending.What is the total number of people the second venue can hold?*What is the set menu for your dinner seminar at your second venue?*Dates for EventFirst Date:* MM slash DD slash YYYY First Date Start Time* : Hours Minutes AM PM AM/PM First Date End Time* : Hours Minutes AM PM AM/PM Second Date:* MM slash DD slash YYYY Second Date Start Time* : Hours Minutes AM PM AM/PM Second Date End Time* : Hours Minutes AM PM AM/PM Third Date:* MM slash DD slash YYYY Third Date Start Time* : Hours Minutes AM PM AM/PM Third Date End Time* : Hours Minutes AM PM AM/PM Presenter InformationAre you utilizing an outside speaker?* Yes No Guest Speaker's Name* First Last Have you confirmed dates with the speaker you are utilizing?* Yes No Make sure you confirm the dates of your event with the speakerHave you made payment arrangements with the speaker you are utlizing?* Yes No Make sure you setup a payment arrangement with the speaker.How many presenters are there for this event?* One Presenter Two Presenters Three Presenters Presenting Advisor's Name* First Last Has the presenting advisor presented before?* Yes No Please provide a company or personal biography for the presenting advisor.*You can also provide a link to the bio if you prefer.Please upload a photo/headshot of presenting advisor.Max. file size: 8 MB. Please upload a company logoMax. file size: 8 MB. What is presenting advisor's state license number?If applicable.Is the presenting advisor appointed with a Broker Dealer or RIA?* Yes No Please select with BD's or RIA's presenting advisor is affiliated with.*CreativeOne Wealth (formerly ChangePath)CreativeOne Securities (formerly Client One)CambridgeBerthel FisherCaltonOtherWhich broker dealer is the presenting advisor with?*Please write out any disclosures we will need to include.*We will need these every time you fill out a questionnaire to make sure your campaign is not delayed.Will you have an office staff member as a moderator for this webinar? Yes No Moderator's Name* First Last Moderator's Email Address* Second Presenter InformationSecond Presenter's Name* First Last Has this person presented before?* Yes No Please provide a company or personal biography for the second presenter.*You can also provide a link to the bio if you prefer.Please upload a photo/headshot of the second presenter.Max. file size: 8 MB. What is the second presenter's state license number?If applicable. Third PresenterThird Presenter's Name* First Last Has this person presented before?* Yes No Please provide a company or personal biography for the third presenter.*You can also provide a link to the bio if you prefer.What is the third presenter's state license number?If applicable.Please upload a photo/headshot of the third presenter.Max. file size: 8 MB. Submission Review{all_fields:nohidden} Terms and conditions apply for guaranteed reimbursements:View our Best Practices and Terms & Conditions.Terms & Conditions* I agree to the terms and conditionsTotal $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Expiration Date Security Code Cardholder Name Disclaimer for Registered Reps:The client has to submit retail communication approval requests for all events. They also have to submit their presentations and all material if it is not already approved. These requests will go in the queue with everyone else. Final approvals have to come from the rep or their assistant.
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