Personal Finance Survey
In 2022, our team is aiming to help 10,000 families strengthen their Financial Literacy. We are providing everyday folks with a variety of tools that the wealthy often use to create and protect a legacy for their loved ones. Please take a moment to fill out the form below to help us understand how we can best serve you! All the Best! ~Daneene
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Which time zone are you in?
*
Pacific
Mountain
Central
Eastern
Other
In which state do you currently reside?
*
Best time of day to contact:
*
Morning
Afternoon
Evening
Other
Answer the following: I am currently a(n)....
*
Employee
Business Owner
Sole Proprieter/Self-Employed
Other
Target Areas
Please rate the following areas of interest/concern on a scale of 0 - 5 ................................. SCALE: 0 = not at all interested/concerned 5 = significantly interested/concerned.
Managing bills and debt
*
1
0
1
2
3
4
2
5
0 is , 5 is
Having emergency funds available
*
3
0
1
2
3
4
4
5
0 is , 5 is
Saving for retirement
*
5
0
1
2
3
4
6
5
0 is , 5 is
Funding for education (self and/or children)
*
7
0
1
2
3
4
8
5
0 is , 5 is
Financial support for children/aging parents/dependents
*
9
0
1
2
3
4
10
5
0 is , 5 is
Financial Growth
I would like more information about...
*
Tax free/deferred savings
Protection from market instability/uncertainty
Increasing cash flow
Operation Restore Hope for Kids
Helping to spread the National Financial Literacy Campaign message
Other
Thank you for helping us with our mission of No Family Left Behind
Submit
Should be Empty: