Financial Wellness Survey
The Synergy Financial team is aiming to help families strengthen their Financial Literacy by providing everyday folks with a variety of tools that most of "Main Street" isn't aware of. Take a moment to complete this survey if you'd like be a part of this mission and help ensure that there is No Family Left Behind!
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
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
*
0
1
2
3
4
5
0 is , 5 is
Having emergency funds available
*
0
1
2
3
4
5
0 is , 5 is
Saving for retirement
*
0
1
2
3
4
5
0 is , 5 is
Funding for education (self and/or children)
*
0
1
2
3
4
5
0 is , 5 is
Financial support for children/aging parents/dependents
*
0
1
2
3
4
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
Helping to spread the National Financial Literacy Campaign message
Financial Wellness Workshops for employees or organizations
Other
Thank you for helping us with our mission of No Family Left Behind
Submit
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