FINANCE 101
Personal Finance Strategy Survey
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
*
First Name
Last Name
Invited by
*
The person who invited you. Full name if possible
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
E-mail
*
Phone Number
*
-
Phone Number
Are you:
Employed
Self Employed
Business Owner
Unemployed
Retired
Personal Challenges:
1. Are you suffering from financial losses as a result of the recent economic downturn?
*
Yes
No
2. Are you concerned about any of the following:
Too many bills or debts?
*
Yes
No
Lack of savings or investments for retirement?
*
Yes
No
Lack of preparation for your kids’ college education?
*
Yes
No
Not having enough protection in case of disability, long term illness or even death?
*
Yes
No
3. Do you carry any significant financial responsibilities with growing children or aging parents?
*
Yes
No
4. Are you concerned about the future of your job or career?
*
Yes
No
5. Do you feel that financial terms such as investments, insurance, debt, inflation and tax are difficult to understand?
*
Yes
No
6. If you were to choose, what would you rather have?
*
Better RETURN for your money
Better SAFETY for your money
Both
7. What is your ideal retirement age?
*
Financial Solutions:
8. Do you want to learn how to get your children into a good college with proper funding?
*
Yes
No
9. Do you want to learn more about how money works and how to build a proper financial future?
*
Yes
No
10. Are you interested in making more money on a part-time basis?
*
Yes
No
11. Do you want to explore a new business career in the fast-growing financial industry?
*
Yes
No
12. Do you know anyone who may need our services or is looking for an opporutnity?
*
Yes
No
Submit
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