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First Name
*
Last Name
*
Phone
*
Email
*
Company Name
*
How long have you been in the business?
Less than 1 year
1-3 years
3-5 years
5+ years
What is your current monthly revenue?
Under $10,000
$10,000 – $20,000
$20,000 – $50,000
$50,000+
What is your monthly marketing budget?
Less than $1,000
$1,000 – $2,500
$2,500 – $5,000
$5,000+
Are you currently running any paid ads (Facebook, Google, etc.)?
Yes
No
Do you have a CRM or system to track leads and customer follow-ups?
Yes
No
Not sure
What’s your biggest marketing challenge right now?
Are you the decision-maker for your business’s marketing?
Yes
No
I share decision-making responsibilities
How soon are you looking to start improving your marketing efforts?
Immediately
Within the next 30 days
1–3 months
Just exploring
Are you open to investing in a done-for-you marketing and automation system that grows your business?
Yes, I’m ready
Possibly, if I see the value
No, I’m just researching
How many leads are you currently getting per month?
0–10
11-25
26-50
50+
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