Consultant Biographical Form for Legacy Licensees

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Home
Colleagues
Profiles
The 4 Institutes
Knowledge
About Us
Log In
Log Out

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Colleagues
Profiles
The 4 Institutes
Knowledge
About Us
Log In
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Take Action

Take Action

Biographical Worksheet

For Legacy Winslow Consultants

*To ensure that our information on you is correct, please complete this form.

Name(Required)

First Last

Company Name(Required)

Company Name

Date(Required)

Month

Day

Year

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Mobile Phone(Required)

✓ Valid number ✕ Invalid number

Office Phone(Required)

✓ Valid number ✕ Invalid number

Email(Required)

Preferred Contact Method(Required)

Phone

Text

Email

LinkedIn URL (if applicable)

Untitled

MARKETING AND EMAIL:

I would like to obtain a @winslowsolutions.com email account (free of charge)

Winslow Email(Required)

Yes

No

What email address would you like? (subject to approval)

Review and sign the Terms and Conditions

MY PROFESSIONAL INTERESTS:

PROFESSIONAL INTERESTS

Marketing the Winslow Profile

Developing Comprehensive Solutions for Businesses

Performance Coaching

Developing Passive Income

Other Interests:

CONSULTANT LICENSE (see Addendum A)

License Selection(Required)

Business Consultant

Senior Consultant

Executive Consultant

ENROLLMENT LEVEL (see Addendum A)

Enrollment Level(Required)

Basic (included)

Premium (paid)

Enrollment Fee(Required)

Premium (Monthly) $79.00

Premium (Annual) $799.00

Enrollment Fee(Required)

Premium (Monthly) $49.00

Premium (Annual) $499.00

Enrollment Fee(Required)

Premium (Monthly) $29.00

Premium (Annual) $299.00

CUSTOM BRANDING OPTIONS (see Addendum D)

Branding Options

None

Silver

Gold

Please email eric@winslowsolutions.com to discuss custom branding in further detail.

------------

Please email eric@winslowsolutions.com complete the payment process.

TERMS AND CONDITIONS:

Consent(Required)

I understand I am required to contact Winslow Solutions in order to set up my recurring payments (if any). These selected features will go into effect after I have completed this step. I understand I may be required to attend retraining at the prevailing costs if I have not reached certain production levels by 24 months from today.(Required)

*When you click "Submit" below, you will still be required to reach out to Eric Samuelson in order to submit payment information for any fees selected above.

CAPTCHA

LinkedIn URL (if applicable)

MARKETING AND EMAIL:

MY PROFESSIONAL INTERESTS:

CONSULTANT LICENSE (see Addendum A)

ENROLLMENT LEVEL (see Addendum A)

CUSTOM BRANDING OPTIONS (see Addendum D)

TERMS AND CONDITIONS:

© [year] Winslow Solutions