Name *

First Name

Last Name

Spouse/Partner Name

First Name

Last Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you drink alcoholic beverages?

Yes

No

Are you on Facebook?

Yes

No

Are you on Instagram?

Yes

No

Are you on LinkedIn?

Yes

No

Trust or will? *

Do you have a trust or will in place?

Yes

No

CFP *

Do you have a CFP?

Yes

No

How do you rate them?

Love them

Could use a new one

CPA *

Do you have a CPA?

Yes

No

How do you rate them?

Love them

Could use a new one