Preserving Your Legacy
Please let us know if you will be able to make our upcoming session.
Which upcoming event will you be attending?
*
Please Select
Will & Estate Planning
Financial Literacy Workshop
Which upcoming event will you be attending?
*
Financial Literacy Workshop
Green Energy Workshop
Will & Estate Planning
Other
Which session dates will you attend?
Which session dates will you attend?
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Month
-
Day
Year
Date
Full Name
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First Name
Last Name
Phone Number
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-
Area Code
Phone Number
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
How many additional people are you bringing (including yourself)?
Please Select
1
2
3
4
5
6
7
8
9
10 or more
Do you currently have a Living Will?
*
Please Select
Yes
No
WILL & ESTATE PLANNING
What is your current housing status?
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Please Select
Homeowner
Live with Family
Rent an apartment
Rent a house
Other
Do you have plans to buy a home?
*
Please Select
Yes, within the next 12 months
Yes, within 1–3 years
Yes, but more than 3 years from now
No
Unsure
Do you currently follow a monthly financial budget?
*
Please Select
Yes
No
Which of the following best describes your approach to managing monthly finances?
*
Please Select
I have a written monthly budget that I follow
I have a general idea of my monthly expenses but no formal budget
I do not track my monthly expenses or budget
Other
What type of life insurance do you currently have?
*
Please Select
Term life insurance
Whole life insurance
Universal life insurance
Variable life insurance
I don’t have life insurance
Other
GREEN ENERGY
Which Green Energy topics are you interested in learning about?
Solar Panels/Battery Backup
Energy Efficiency/Lowering Electric Bills
Weatherization
Energy Rebates & Incentives
EHome Energy Audits
Community Solar
All the above
Is your monthly electric bill generally:
Please Select
Under $100
$100-$150
$151-$200
$201-$300
Over $301
Not sure
Which electric company provides your electricity?
Will you need a translator?
*
Please Select
No
Yes
What other services are you in need of?
Do you know of any churches, neighborhoods, or community groups that would benefit from hosting an Anti-Displacement Info Session? If so, please provide their name(s), location(s), and contact information (if available).
How did you hear about us?
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