Personal Financial Strategy Survey

Name:   
Address:
Phone:   
Email Address:
Are you an employee self-employed business owner

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 investment for retirement or kid's 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 like terms such as investments, insurance, debt, inflation, and taxes are difficult to understand? Yes                       No 6. Do you think there is a large number of people in our country who struggle financially and need help to improve their financial situation? Yes                       No 7. If you were to chose, what would you rather have? Better return for your money Better safety for your money 8. What is your ideal retirement age? Financial Solutions: 9. Do you want to learn more about how money works and how to build a stronger financial future? Yes                       No 10. Are you interested in making more money and increasing your cash flow? Yes                       No 11. Do you want to explore a new business career in the fast growing financial industry? Yes                       No