LeadJig Event Questionnaire Step 1 of 4 25% Name:* First Last Please confirm the advisor's name.Email:* Please confirm the agent's email addressPhone Number:*Please confirm the advisor's phone number.Company Name:*Please confirm your company name.Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Website address (URL):*Do you have an assistant that will be helping out with your event?* Yes No Assistant Name:* First Last Assistant Email:* Assistant Phone Number:* Event InformationPlease choose your event type* Dinner Seminar Workshop Choose your dinner seminar topic* Surviving Retirement Volatility to Opportunity Estate Planning Women's Only Taxes Choose your workshop topic* Estate Planning Social Security Class If you choose an alternate topic, it will not be guaranteed.Prospect criteria you would like to target in the campaign (if known)Ages: Assets: Any other specific criteria:What is the total number of mailers you would like sent out?*The minimum amount is 6000 mailers.Which style of mailer would you like?*Wedding StyleSelf-MailerPostcardNot sure - let's discussLeave blank if unknown/undecidedDo you want to add digital ads to your campaign?* Yes No Maybe - let's discuss How many dates are you registering for?* One Date Two Dates Three Dates If the venue can only hold a limited amount of people, we highly recommend having two dates.Name of the Venue*Venue selection is very important to the success of your campaign. We suggest reviewing our best practices to ensure event success. https://bit.ly/2S8xP1RVenue Address* Street Address 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.Examples: parking, buildings, rooms, etc.What is the total number of people the venue can hold?* First Date DetailsFirst Date:* MM slash DD slash YYYY Event Start Time* : Hours Minutes AM PM AM/PM Event End Time* : Hours Minutes AM PM AM/PM Second Date DetailsSecond 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 DetailsThird 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 InformationPlease provide a personal biography for the presenting advisor.*You can also provide a link to the bio if you prefer.What is the presenting advisor's state license number?If applicable.Is the presenting advisor a registered rep?* Yes No 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.Please upload a photo/headshot of the presenting advisor.Max. file size: 8 MB. Please upload your company logoMax. file size: 8 MB. Will the advisor be presenting with anyone else?* Yes No Please list out the names, state license numbers (if applicable), and biographies for the other presenters.*Name State License BiographyPlease upload a photo/headshot of the other presenter(s). Drop files here or Select files Max. file size: 8 MB. Submission Review{all_fields:nohidden} Untitled
