Last Name: 

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How do you prefer to be contacted: Phone E-Mail Instant Messenger US Mail

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Best Time to Call:  Anytime 8 a.m. 9 a.m. 10 a.m. 11 a.m. 12 p.m. 1 p.m. 2 p.m. 3 p.m. 4 p.m. 5 p.m. 6 p.m. 7 p.m. 8 p.m.   EST CST MST PST

Preferred Instant Messaging ID: 

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What interests you most about a business with Mia Bella Gourmet Candles? 
Please be specific.

How did you find me? I'm searching for a home-based business Friend Co-worker Surfing the Web Yahoo Group Internet Ad Print Ad Craft Show/Open House Other

If you chose "Other" please explain: 

Did someone Refer You to me? 

Are you seriously interested in a home-based business?  Yes, very serious! Maybe I have no idea No

What is your interest level, based on current knowledge?  I'm a 10 -- I'm Ready to Join Now! I'm a 7 or Higher -- More Info, Please I'm a 5 I Have No Idea

Are you interested in learning how to create multiple income streams that grow? Yes! Maybe No! I have no idea I don't understand the question

Are you willing to go through a fact finding process to get all your questions answered? That means a phone call or email  to see what we expect of each other. Yes, absolutely! Maybe No! I have no idea I don't understand the question

Have you ever owned a business?   Yes No

What is your primary reason for wanting to work from home? Please be specific.

What is most important to you in a home-based business? The ability to stay home with my children The ability to work at home using the internet Well established, debt-free company To be coached, trained and shown exactly what to do! Easy for anyone to do regardless of computer skills Unlimited Income Potential All of the Above I have no idea

Do you have previous Network Marketing experience? No, what is network marketing? Yes, I've been involved with Network Marketing Never, but curious Is this a scam?

Are you currently involved with a Network Marketing or Direct Sales company? No Yes, but I'm interested in changing companies Yes, but I want to remain with my current company as well

What is your current occupation and/or company affiliation?

How much would you like to earn in this business per month?  $100 $500-$1,000 $5,000-$10,000 $10,000 +

Have you, or do you want to work with leads? These are people whom you have not met, but who have expressed an interest in earning an income from home. Yes!  I have no friends left Maybe, let's talk about it If my friends say no, I'm not doing this! I already use leads Whatever it takes!

How much time per week are you willing to commit to this business? 1-5 Hours 5-10 Hours 10-20 Hours Fulltime I don't have time to commit right now

Part of his business is based on the fact that millions of people  are logging onto the Internet each and every day.  A large percentage of them would like to have their own business.

If you were convinced beyond a shadow of a doubt that the products and the financial potential of this business were honestly the opportunity of a lifetime, how much would you be willing to invest in your future? $50 $100 $250 $1,000 + Running a business costs money????

Thanks, and congratulations for taking the time to invest a few minutes in your future.  If we mutually agree this is for you, you will be mentored and trained by the best in the industry for free.  People that know how to get results!

By taking these few moments, I promise you that you will have the ability to make a profound difference, not only in your life, but in the lives of many!

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