Introduction Meeting Questionnaire

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First Name

Last Name

Email

Phone

Do you currently own any life insurance? *

Yes

Not yet

How much and what type?

How much research have you done about The Infinite Banking Concept®? (select all that apply) *

I'm starting from scratch

I've dabbled some on the web

I’ve read “Becoming Your Own Banker” by Nelson Nash

I've spent multiple hours “down the rabbit hole”

I'm a fellow Industry Pro

Product Type I'm most interested in: (select all that apply) *

Whole Life Insurance & Infinite Banking

Term Life Insurance

Disability Insurance

Indexed Universal Life (IUL)

Annuities/Retirement Planning

Premium Financing

Not sure yet

Are there any specific questions you want to make sure we cover?

Please keep in mind all information is confidential and is not shared without your specific permission.

CORAL SPRINGS, FL 33071

The Infinite Banking Concept® Authorized Practitioner.

THE INFINITE BANKING CONCEPT® financial system and the BECOMING YOUR OWN BANKER® financial program are Registered Trademarks.

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