Personal Door Knocking Form
Pipeline Status
Newsletter Sign Up
Lead Status
*
💵 - Customer: Has made a purchase
✅ - Hot Lead: Strong potential to become a customer soon
🔁 - Follow-Up: Needs follow-up, likely to convert
❌ - Dead Lead: Not interested or no chance of converting
🚫 - Not There: Never responded or no interaction at all
Did we leave them the door knocking packet?
Yes
No
Route
No Route
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Would they be interested in learning more about our membership program?
Yes
No
Would they be interested in a milk route?
Yes
No
Where Did You Hear About Us
*
Facebook
Instagram
Tik Tok
Youtube
Kinney Parking Lot
Delivery Truck
Google Maps
Google Search / Google Reviews
Knocked On Your Door
Flyer
Signs
Friends/Family
Italian Affairs
Local Business Referred Us
Other
Never Heard Of Us Before
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Address
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State
Country
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
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Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D"Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guadeloupe
Guam
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Guyana
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Heard Island and McDonald Islands
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Hungary
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Indonesia
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Iraq
Ireland
Isle of Man
Israel
Italy
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Republic of Korea
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Land Islands
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North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Federated States of Micronesia
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Eswatini
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
UK
Ukraine
United Arab Emirates
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
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Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
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Postal code
Apartment Number
SMS Consent
Yes, I agree to receive SMS Messages
Mark yes if they are ok with sms messages
Email
Phone
Full Name
Standing Orders
Needs Delivering
Completed
Purchased At Door?
Yes
Comments
Quick Repetitive Notes
Interested but didn't purchase anything. Harder Sell
Loves Mobile Market offer
Very Likely to turn into a member
Zone 1 Morning
Zone 1 Afternoon
Zone 2 Morning
Zone 2 Afternoon
Zone 3 Morning
Zone 3 Afternoon
Zone 4 Morning
Zone 4 Afternoon
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