• 1

    Hi.. What is your name?*
  • 2

    What city are you in?
    • A

      Adelaide

    • B

      Brisbane

    • C

      Gold Coast

    • D

      Melbourne

    • E

      Newcastle

    • F

      New Zealand

    • G

      Perth

    • H

      Sydney

    • I

      Tasmania

  • 3

    Are you?*
    • A

      Male

    • B

      Female

  • 4

    What age bracket are you?
    • A

      18-23

    • B

      24-29

    • C

      30-39

    • D

      40+

  • 5

    What is your mobile/cell number?*
  • 7

    What would you like to earn a month?
  • 8

    Rate yourself as a networker
  • 9

    Rate yourself as a social influencer
  • 10

    What is your main priority in life?
  • 11

    What is your level of desire to succeed?
  • 12

    How many followers do you have on LinkedIn?
  • 13

    How many followers do you have on Twitter?
  • 14

    How many followers do you have on Instagram?
  • 15

    How many friends do you have on Facebook?
  • 16

    How many days a week can you dedicate to this opportunity?
  • 17

    Are you committed to your own success and working with Australia and New Zealand’s best Networking and Leadership Team?