Caller Intake Form

Contact Information

Full Name

Email

Phone Number

City, State

Time Zone

Are you fluent in English?

Yes No

Do you have a reliable internet connection and a quiet place to work?

Yes No

Are you comfortable working on a commission-only basis?

Yes No

Are you comfortable with outbound calling?

Yes No

Are you willing to follow a provided calling script exactly?

Yes No

Select how many hours per week you can reliably commit:

Have you done outbound cold calling before?

Yes No

Type the word CHICAGO exactly as written:

I agree to be contacted by Domestic Telemarketing via phone, text, or email.