Financial Campaign Survey
Sign in to Google to save your progress. Learn more
Email *
How did you first learn about the Workshop? (Name of the Organization or Inviter) *
PERSONAL CHALLENGES:
1. Are you still suffering from financial losses as a result of the recent economic downturn? *
2. Are you benefiting from the current economy? *
3. Are you concerned about any of the following:
* Too many bills or debts? *
* Lack of savings or investments for retirement? *
* Lack of preparation for your kids' college education? *
* Not knowing enough about your Medicare options? *
* Paying too much for health insurance but not getting enough benefits? *
* Not having enough protection in the case of disability, long term illness or even death? *
4. Do you support children, aging parents or other dependents? *
5. Are you concerned about the future of your job or career? *
6. Do you feel that financial concepts that involve investments, insurance, debt, inflation, and tax are confusing? *
7. When saving and investing, what would you rather have for your money? *
8. What is your current age? *
9. What is your ideal retirement age? *
FINANCIAL SOLUTIONS:
10. Do you want to learn how to fund your child's college or university costs? *
11. Do you or does anyone you know need help with health care options? *
12. Do you want to learn more about how money works and how to build a stronger financial foundation? *
RETURN APPOINTMENT:
QUESTION & ANSWER SESSION
I understand that the question and answer session is for one hour and that is included as part of this class. I understand that there is NO COST for my one-on-one session with the Instructor. Any other meetings will be by my choice and at my discretion.
What is your time zone?
Clear selection
Which Day of the Week and Time for Return Appointment: *
Required
What Date for Return Appointment
MM
/
DD
/
YYYY
Location of the Appointment Preferences *
Required
CONTACT INFORMATION
Name: *
Address:
Phone: *
Are You An
Clear selection
Name of Your Company:
Which Workshop(s) Have You Attended?
What did you get out of today's session? 
How might you apply today's lessons?
What didn't work for you and/or how can we help to improve?
What are you expecting from the 1 on 1 session?
What organization(s) you think can also benefit from our Free Financial Workshops? (Please give us the name of the organization, Contact Name and Phone/Email)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms