Referral Partner Lead Registration Form

Thank you for your interest in being a Referral Partner for Leaders Today.

Please complete this Referral Partner Lead Generation form with details regarding your referral.

After your submission, a referral agreement will be sent to you with details of the referral percentage amount and payment terms. One of our team may contact you for further details.

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* 1. Partner (your) company name

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* 2. Your name

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* 3. Your work email

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* 4. Your Phone

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* 5. Prospect company name

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* 6. Prospect company location

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* 7. Prospect company's contact name

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* 8. Prospect company's contact title

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* 9. Prospect company's contact email

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* 10. Prospect company's contact phone

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* 11. Solutions of interest

Executive coaching

Leadership coaching

Team coaching

Leadership development program

Organizational culture change

HR consulting

Other (please specify)

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* 12. Estimated number of users

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* 13. Referral origin

Leaders Today requested you to refer them to the prospect company.

You gave a referral about Leaders Today to the prospect company without first informing Leaders Today.

You offered to Leaders Today to give them a referral to the prospect company.

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* 14. Are you employed by, or have other roles in the prospect company?

Yes

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* 15. Additional comments about this opportunity

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* 16. What next step do you require at this stage?

Discovery call with prospect company's contact

Demo

Services estimate

Pricing list

Other (please specify)