Apply for Consultation

You can always press Enter⏎ to continue

Now create your own JotForm - It's free!Create your own JotForm

Create your own JotForm

JotForm

JotForm mascot Podo

Question Label

1 of 17See AllGo Back

Becoming Your Own Banker Consultation

Fill out this form to see if you qualify for a free 30 minute consultation to become your own banker.

17Questions

1
Are You Employed?* This field is required.
YESNO
2
Where do you work?
3
What is your annual income?
4
Are you...* This field is required.
Business Owner
Employee
5
As a business owner, are you on T4'd income or do you take dividends?
T4 Income
Dividends
Both
I don't know
6
Do you own your home?* This field is required.
YESNO
7
What is your home value?
8
How much do you owe on your home?
9
What is your monthly payment on your mortgage and what is your interest rate?
10
When is the next mortgage renewal date?
11
Do you have mortgage insurance?
YESNO
12
Do you have any other debts? If so, what are they and how much?* This field is required.Eg: Vehicle lease, line of credit, etc
Small
Normal
Large
Huge
Ok
Ok
13
Do you have any savings or investments? If so, provide details* This field is required.
Small
Normal
Large
Huge
Ok
Ok
14
Do you have any life insurance? If so, please provide details. * This field is required.
Small
Normal
Large
Huge
Ok
Ok
15
Name* This field is required.
First Name
Last Name
16
Email* This field is required.
example@example.com
17
Phone Number* This field is required.
Area Code
Phone Number
Should be Empty:

Save & Continue Later

Your form is saved successfully!

If you want to continue answering your form later, please enter the email address you would like to send the link to:

Please enter a valid email address.

Something went wrong while saving your answers. Please try again.

Email has been sent successfully.

Save your progress

OR

Already have an account? LOGIN

Skip Create an Account

Save your progress

Name

Email Address

Password

I agree to theTerms of ServiceandPrivacy Policy

Your form submission has been saved as a draft.

If you want to continue answering your form later, please enter the email address you would like to send the link to:

Save your progress

OR

Username or email

Password

Forgot Password?

Your form submission has been saved as a draft.

We’ve sent you an email with a link to complete your submission.