First Name
*
Last Name
*
Email
*
Phone
*
Date of birth
*
Proper Name
Licensed Status
*
Licensed
Unlicensed
Prelicensing
Send Xcel
NPN Number
*
Lines of Authority
Life/Health?
Life Only
Health Only
Life & Health
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Onboard Date
*
Comp Level
*
TBD
Representative 85
Agent 90
Advisor 95
Senior Advisor 100
Executive Advisor 105
Area Sales Manager 110
District Sales Manager 115
Regional Sales Manager 120
National Sales Manager 125
National Sales Director 130
National Agency Director 135
Board Member 140
Executive Board Member 145
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Primary Vertical
*
Life- Simplified
Medicare
Life- Advanced
Retirement
Debt Elimination
ACA
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FE Telesales?
Yes
Street Address
City
State
*
Postal code
Send to CRM
Heirarchy
Trustworthy
Axios
Clark
Colson
Lighthouse Legacy