Enrollment Questionnaire for New AdvisorPR Clients

- First Name:
  
  Middle Name or Initial:
  
  Last Name:
  
  Company Name:
  
  Professional Title / Preferred Title:
  
  Office Telephone Number:
  
  Invalid format.Must contain 10 digits and is a required
  
  Toll-Free Telephone Number:
  
  Invalid format.
  
  Mobile Telephone Number:
  
  Invalid format.Mobile telephone must be formatted with 10 digits
  
  Office Fax Number:
  
  Invalid format.
  
  E-mail Address:
  
  Website Address:
  
  Main Office Address:
  
  City:
  
  State:
  
  Zip:
  
  County:
  
  Other Office Locations (city and state):
  
  City You Live In (if different than office location):
  
  Date of Birth (Optional):
  
  Assistant Name:
  
  Assistant E-mail:
  
  Assistant Office Phone:
  
  Invalid format.

About You

- How many years (collectively) have you been in the financial services industry? What area(s)?:
  
  What licenses and designations do you hold? :
  
  What is the professional title you use and why?:
  
  Why and how did you enter into the financial services industry?:
  
  What do you like most about what your profession?:
  
  In what industry membership groups, organizations and/or activities are you involved?:
  
  In what community memberships, organizations and activities are you involved?:
  
  What awards or acknowledgments have you received in your profession?:
  
  What awards or acknowledgments have you received in your community?:
  
  Did you attend college? If so, where did you attend and what degree(s) did you earn?:
  
  What other professional work experiences did you have before your current position?:
  
  Have you authored a book? If so, what is the title and when was it published?:
  
  Have you had any other notable professional accomplishments that you would like to share?:
  
  Would you like us to include any personal information (e.g. family members, hobbies, hometown) in your marketing and/or PR materials? If so, please include here.:

About Your Firm

- What year was your company founded?:
  
  What is your company’s slogan or tagline? Why?:
  
  Who, specifically, do you serve?:
  
  What is (are) your area(s) of specialty (e.g. Rollovers, Income Planning, etc.)? If you don’t have one established, for what would you like to be recognized?:
  
  How many people do you have on staff? Are they sales, support or operations? Please explain.:
  
  *If you would like any staff member included in your marketing or PR materials, please have them complete a separate enrollment form.
  
  What services does your company offer? Please select the services as described by your firm. (For example, if you offer “distribution planning” and market the service under this name, then you may not need to select “income planning” as well.):
  
  Retirement Planning Financial Planning Financial Advising Income Planning Wealth Accumulation Wealth Management Money Management Investment Planning Asset Protection Asset Preservation Risk Reduction Insurance Long-Term Care Planning Retirement Income Planning Tax Reduction Tax Planning Distribution Planning Rollover Specialist Transition Planning Estate Planning Succession Planning Business Services Comprehensive Financial Plans Comprehensive Retirement Plans
  
  Other:
  
  Please give us a quick overview on how you categorize your services and/or explain them to your prospects.:
  
  Do you employ a CPA, attorney or other specialist?:
  
  Do you collaborate with CPAs, attorneys or other specialists on a client’s behalf? If so, please explain.:

More Details

- Are you securities licensed? If so, which licenses do you hold?:
  
  Do you have a Broker Dealer?:
  
  Do you require Broker Dealer approval on marketing, advertising and public relations materials?:
  
  Do you work under a Registered Investment Advisor?:
  
  Is your firm the Registered Investment Advisor?:
  
  If applicable, please include your disclosures here.:
  
  Have you had any negative experiences that could potentially impact your public image? If so, please explain.:
  
  Is there anything unique about your experiences that you would like for us to highlight?:

Branding & Marketing

- Describe the age and characteristics of your target demographic.:
  
  What is your primary goal for your clients?:
  
  What are the biggest concerns you hear from your clients with respect to their finances?:
  
  When someone asks you “What do you do for a living?” how do you describe your occupation and business?:
  
  What do you consider to be your competitive advantage?:
  
  What is your primary source of lead generation?:
  
  What other marketing vehicles are you using to attract and retain new business?:
  
  What does your call to action offer? (e.g. free consultation, report):
  
  If AdvisorPR is designing a logo, website or other marketing material, do you have a preference on style, colors or other companies that you would like to benchmark creatively? Please explain:

Media Experience

- Please explain any previous media experiences. (i.e., Quoted in the paper or interviewed on television? About what topic were you interviewed? What was the outcome?):
  
  Do you have a radio show or television segment? If so, what is the format? What is it called? What stations(s) broadcast the show or segment? How long have you been doing this?:
  
  Do you currently contribute editorial content to a local or industry publication? If so, what is the publication? How frequently do you write for the publication and how long have you been writing for them?:
  
  Have you ever been featured in an industry publication? If so, what publication, when did the feature run and what was the topic?:
  
  Do you have experience on camera? Are you comfortable being on camera?:
  
  What are some of your favorite media outlets (local and national)?:

Practice Goals

- Where would you like to see your practice in two to five years?:
  
  What would you like to accomplish with AdvisorPR?:

Form Security

- Which day comes before sunday?
  
  Please answer the security question: *
  
  Incorrect response; please try again