Prospect Information Form

Name: ____________________________________
NOTES:
Address: ___________________________________
_________________________________________
Hm#: ________________ Cell#: _______________
Email: ____________________________________
Family Situation: _____________________________
Occupation: _________________________________
Recreation/Hobbies/Interests: _____________________
Motivation: ________________ Interest Level 1-5: _____

Lifestyle Prospect: Location___________ Date_______

Met at HS of____________________Date_______
Referral from______________________________
Past/Future Hostess: Last/Next HS Date____________
Provided OP literature to read over on_______________
Presented marketing plan/OP on__________________
Choose One:
Choose One:
Choose One:

2+2+2
Flip Chart
OP Brochure
Group
One on One
By Phone
Purse Nt
Charm Br
Gift Card $_____

Ph Call Date: ______ Reason: _______________

______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________
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Result: _______________________________
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Appt. Date:
Reason:
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Ph Call Date: ______ Reason: _______________

______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________
______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________

______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________
______ Time: ____ Place: _________
Result: _______________________________
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Appt. Date:
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Ph Call Date: ______ Reason: _______________

______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________
______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________
______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________
______ Time: ____ Place: _________
Result: _______________________________
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Ph Call Date: ______ Reason: _______________
______ Time: ____ Place: _________

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Result: _______________________________
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Ph Call Date: ______ Reason: _______________
______ Time: ____ Place: _________
Result: _______________________________
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Reason:
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