Date of Seminar
Please rate the speaker (10 being highest, 1 being lowest)
10 - great speaker
1 - poor speaker
Comments about speaker / program - improvements, what we can do better, etc.
Would you like a no-obligation meeting with Ted Kuczek to discuss your estate planning?
Do you prefer an in-person meeting or a virtual meeting?
What time of day is best to contact you?
When would you like your meeting?
Within 2 Weeks
In A Month
After A Month
What time of day would you prefer for your meeting?
Street Address Line 2
State / Province
Postal / Zip Code
Current Estate Plan
Power of Attorney - Property
Power of Attorney - Health
Prefer not to answer.
I would like Ted to give a seminar to a group to which I belong.
I would like a seminar packet for a friend / spouse who couldn't attend the seminar.
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