In-Take Lead/Sales Form

In-Take Form Section

Name

First Last

What state is the salon in?

How did you hear about Aerovex? Have you been to our website?

What prompted your call today?

What's the name of your (or the) salon?

Is your salon open already?

Yes
No

[ONLY if answered NO above] When are you planning to open?

What type(s) of services do/will you offer?

How many mani and/or pedi stations, keratin chairs, or lash beds?

On average, how many services will be done every week?

Are there any concerns about any unhealthy symptoms? (Use options below to give examples)

What type of air purification systems are you using to get rid of the dust, vapors & odors?

What is the size of the salon space (just approx sq ft)?

How high are the ceilings? (ex. 8, 9, 10 ft)

Would you like to speak to Keith, our salon code expert?

Yes
No (If no, emphasize it could help them save $$)
No, just need to place an order (they already spoke with Keith)

Phone

What's your best email

Notes about prospect

When will you need delivery? (If they're hesitant to say, "We just need to know to prevent any delays")

Products | Quantity | Pricing | Comments

Shipping Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Cost

Be sure to get cost from Lucas if shipping is palletized.

Total (with shipping)

Filter/Carbon Replacement Schedule

4 Months
6 Months (most popular choice)
12 Months
Choose Later (Reiterate benefits of scheduling now)

(HELPFUL TO SAY TO CUSTOMER) Three Reasons to Schedule at time of purchase... #1 - Extends their warranty from 1 year to 3 or 5 years (depending on system) #2 - They will earn Loyalty Rewards Points they can use toward future purchases #3 - It ensures their business continues to run smoothly because it prevents them from forgetting their replacement.

Payment Info & Special Billing Instructions

(Add PayPal email address if applicable) Full Name on Credit Card Credit Card Type (Do NOT type last 4 #'s here, send in separate email) CC # Exp Date CCV Code Billing Address (if different than shipping)

Payment Plan*

Do they want to make a full payment, partial payment, or use Paypal, etc.?

Who is filling out this form?*

First

In-Take Lead/Sales Form

In-Take Form Section

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