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Name

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Select Your Income Range

Date of Birth

All three investment options arrive at the same place, but they take different paths.
Which investment would you prefer going forward?

Line 1

Line 2

Line 3

In the past, how have you managed your investments?

Very Conservatively

Somewhat Conservatively

Moderately

Somewhat Aggressively

Very aggressively

How do you think that you should manage your investments in the future?

Very Conservatively

Somewhat Conservatively

Moderately

Somewhat Aggressively

Very aggressively

Do you need to use your investments for current income?

Yes

How Secure is your income?

Very Secure

Somewhat Secure

Not Secure

If you were given an extra $1000/month, what would you do with it?

Save It

Spend It

Spend Some, Save Some

How soon might you need to take more than half of the money out of your investment account?

Within 1 Year

Within 5 Years

Within 10 Years

Longer Than 10 Years

Carefully weigh the potential gains against the potential losses as described in the chart. Which investment would you be most comfortable with?

Bar A

Bar B

Bar C

Please check any companies that you would not feel comfortable investing in.

Alcohol Companies

Tobacco Companies

Gun Companies

Oil and Gas Companies

Defense Contracters

Gambling Companies

Mining Companies

Companies that do animal Testing

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