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South Africa
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Leads capture form
Please fill out all fields below to ensure the lead is properly captured in the Floatpays system
Leads Capture Form
Relationship Manager / Account Execute details
Full name
Email address
Phone number
Client details
Company name
Preferred contact person
Contact person phone number
Contact person email address
Role at the company
Interested
Interested
Interested
Not interested
Ready to sign up
Interested, but has questions
Interested, but not now
Number of employees
Payroll system
Has given consent to share details with Floatpays?
Yes
Additional comments
Submit
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