Internal Lead Intake Contacts that are entered into this form should be from places like phone calls, Facebook Messages, etc. Once the form is submitted, a contact will be added into ActiveCampaign, JobNimbus, and into the Marketing Lead for spreadsheet. First Name* Last Name* Phone Email* Street Address City State Zip Code Type of Work Insurance Retail Repair Insurance Carrier Source Facebook Google TV Commercial Billboard Word of Mouth Other Referred by: Notes Assign Sales Rep Aaron Brookens Adrian Herra Barry Lervik Brian McGuire Chuck Weber Clayton Rasmussen Darren Jenkins Jacob Johnson Jon Jorgensen William Knight Submit
