GOOD MONEY SKILLS 30-DAY MONEY RESET ASSESSMENT
A practical financial check-in to understand where you are, identify what needs attention, and build a plan for your next 30 days.
Instructions:
Please answer as accurately as you can. Estimates are welcome. If you do not know an amount, leave it blank rather than entering zero. Use your local currency for all money amounts.
Privacy reminder: Do not enter passwords, bank account numbers, government identification numbers, or other sensitive account details.
1. ABOUT YOU
1. Which age range are you in? * Suggested Jotform field: Single choice
*
18–24
25–30
31–40
41–50
51–60
61+
2. Where do you currently live? * Suggested Jotform field: Dropdown
*
Canada
United States
United Kingdom
Other
3. What best describes your employment situation? * Suggested Jotform field: Single choice
*
Employed full-time
Employed part-time
Self-employed / business owner
Contract / freelance
Retired
Unemployed / seeking work
Student
Other
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4. What best describes your household? *
*
Single
Married / living with a partner
Single parent
Living with family
Shared household / roommates
Other
5. How many people financially depend on you?
0
1
2
3
4
5 or more
6. How often do you receive your primary income? *
*
Weekly
Every two weeks / biweekly
Twice a month
Monthly
Irregular / varies
Other
2. YOUR INCOME
7. What is your total monthly take-home income? *
*
8. Do you receive income from other sources?
9. How stable is your income? *
*
Very stable – consistent every month
Mostly stable – small variations
Unpredictable – changes significantly
Irregular – no consistent schedule
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10. Does your income comfortably cover your monthly expenses? *
*
Yes, with money left over
Usually, but it is tight
Sometimes, but not consistently
No, I regularly struggle to cover expenses
Optional: What is your biggest income-related concern?
3. YOUR SPENDING
11. Housing (rent or mortgage)
12. Utilities
13. Groceries
14. Restaurants and takeout
15. Transportation and fuel
16. Car payment
17. Insurance
18. Phone and internet
19. Childcare / education
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20. Subscriptions and memberships
21. Other monthly expenses
22. How do you currently track your spending?
*
Budgeting app
Spreadsheet
Banking app / account statements
Pen and paper
I don't track my spending
Other
23. How often do you have money left before your next payday?
Almost always
Most of the time
Sometimes
Rarely
Never – I run out before payday
24. Where do you feel you overspend most often?
4. DEBT
Credit cards, car loan, student loan, personal loan, mortgage, other, or none
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26. Approximately how much total non-mortgage debt do you have? Suggested Jotform field: Dropdown; ranges are illustrative in local currency
$0 – no debt
$1 – $5,000
$5,001 – $10,000
$10,001 – $25,000
$25,001 – $50,000
$50,001 – $100,000
Over $100,000
Prefer not to say
27. How much do you pay toward debt each month? Suggested Jotform field: Number
28. Do you know the interest rates on your debts? Suggested Jotform field: Single choice
Yes, all of them
Some of them
No, I don't know
29. How confident are you in your current debt repayment strategy? *
*
Very confident
Somewhat confident
Not very confident
I don't have a strategy yet
Optional: What frustrates you most about your debt? Suggested Jotform field: Paragraph
5. SAVINGS
30. Do you currently have an emergency fund? *
*
Yes, enough for 3-6 months of expenses
Yes, but less than 3 months
I have some savings, but no dedicated emergency fund
No emergency savings
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31. Approximately how much do you currently have in savings? Suggested Jotform field: Single choice; ranges are illustrative in local currency
$0
$1 - $500
$501 - $1,000
$1,001 - $5,000
$5,001 - $10,000
$10,001 - $25,000
Over $25,000
Prefer not to say
32. How much are you currently saving each month? Suggested Jotform field: Number
33. What is your biggest barrier to saving? Suggested Jotform field: Single choice
Not enough income
Too many monthly expenses
Debt payments
Unexpected expenses
Impulse spending
I don't have a savings plan
Other
Optional: If an unexpected $1,000 expense came up today, how would you handle it? Suggested Jotform field: Single choice; adapt currency wording if needed
Pay from savings
Pay from available income
Use a credit card or borrow
I would struggle to cover it
Not sure
6. MONEY HABITS
34. Which statement best describes your relationship with money? Suggested Jotform field: Single choice
I feel in control and confident
I manage, but I want to do better
I often feel stressed or overwhelmed
I avoid looking at my finances
I feel like I am constantly playing catch-up
GOOD MONEY SKILLS | 30-DAY MONEY RESET
Page 6
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35. Have you tried budgeting before?
Yes, and I still use a budget
Yes, but I struggled to stick with it
Yes, but it didn't work for me
No, I have never created a budget
36. What is your biggest financial challenge right now?
37. On a scale of 1–10, how confident do you feel managing your money?
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1 = Not confident; 10 = Very confident
7. YOUR GOALS
38. What is your most important financial goal over the next 12 months?
*
39. How much would you ideally like to save each month?
40. How much additional money would you like to have available each month?
41. What is the one financial problem you most want to solve in the next 30 days?
*
Create a realistic monthly budget
Stop overspending and control spending
Get ahead of my bills
Reduce or pay off debt
Start or grow emergency savings
Increase income
Build better money habits
Understand where my money is going
Other
42. What does financial freedom mean to you?
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CONSENT & SUBMISSION
*
I understand that my answers are being used to prepare a personal financial education assessment. I will not include passwords, bank account numbers, government identification numbers, or other sensitive account details.
Suggested Jotform field: Required checkbox with the full confirmation statement above.
Thank you for taking this step toward stronger money skills. Your Money Reset starts with understanding where you are today.
Good Money Skills
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