IUL ACADEMYPre-Academy Survey Chicago, IllinoisJuly 21-23, 2025 Name appearing on government photo ID:*Preferred Name on name badge:*Date of Birth* MM slash DD slash YYYY Gender* Male Female Phone*Mobile*Email* Flying or Driving*SelectFlyingDrivingAirport Departure City:Airline Seat Preference:Frequent Flyer # and Airline:TSA/Global Entry #:Emergency Contact Name*Emergency Contact Phone*List your traveling companions if applicable:*Dietary Requirements:Special Requests:Shirt Size*Women's SmallWomen's MediumWomen's LargeMen's SmallMen's MediumMen's LargeXL2XL3XLWhat percentage of your business is in the following categories:Life*Please enter a number from 0 to 100.Annuity*Please enter a number from 0 to 100.Med Supp/Advantage*Please enter a number from 0 to 100.Securities/AUM*Please enter a number from 0 to 100.LTC*Please enter a number from 0 to 100.Other*Please enter a number from 0 to 100.If you are mainly an annuity producer, what percentage of your annuity business is:Fixed*Please enter a number from 0 to 100.Indexed*Please enter a number from 0 to 100.Variable*Please enter a number from 0 to 100.If you are mainly a life producer, what percentage of your life business is:Universal Life - Traditional*Please enter a number from 0 to 100.Indexed Universal Life*Please enter a number from 0 to 100.Variable Universal Life*Please enter a number from 0 to 100.Single Premium Life - Wealth Transfer*Please enter a number from 0 to 100.Whole Life*Please enter a number from 0 to 100.Term*Please enter a number from 0 to 100.Do you perform annual reviews?*SelectYesNoWould you like help in making reviews profitable?*SelectYesNoDo you plan on taking the Series 65 test in the next year?*SelectYesNoAre you doing any client appreciation events?*SelectYesNoHow would you describe your main market?*SelectSenior MarketBusiness MarketEstate PlanningHealth MarketFamilyMoney ManagementOtherWhat additional products or concepts are you looking to incorporate into your practice?*How much volume do you expect to write in 2025?Life*Annuity*Securities/AUM*Who are your top two go-to life companies?1.*2.*Who are your top two go-to annuity companies?1.*2.*Securities License and/or designations held:*Broker dealer/RIA affiliation:*Are you currently using a lead system? If so, what type?* Seminars & Meals Direct Mail Internet Marketing Online Leads Telemarketing Purchased Lists Other Are you currently using any social networking outlets? If so, what outlet(s)?* Facebook LinkedIn Twitter Blog Other Do you have a website?*SelectYesNoDo you have a recognizable brand?*SelectYesNoHave you utilized search engine or email marketing?*SelectYesNoDo you use a CRM?*SelectYesNo Δ
