Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name *Contact Phone Number *Contact Email Address *1. Are you currently employed? *YesNoI’d like some help.2. Is your cash flow positive each month? *YesNoI’d like some help.3. Are your financial accounts up to date in case of an emergency? *YesNoI’d like some help.4. Do you have an emergency savings account? *YesNoI’d like some help.5. Are you having trouble keeping track of your finances? *YesNoI’d like some help.6. Do you have financial goals? *YesNoI’d like some help.7. Do you know your credit score and/or have you established personal credit? *YesNoI’d like some help.8. Does your personal bank account incur any fees? *YesNoI’d like some help.9. Are you taking advantage of tax credits available to you? *YesNoI’d like some help.10. Are you interested in investments opportunities? *YesNoI’d like some help. tax 13. Have reviewed 11. Are you currently contributing to or interested in a retirement plan (like a 401(k) or IRA)? *YesNoI’d like some help.12. Are you currently using or interested in a Health Savings Account (HSA)? *YesNoI’d like some help.13. Have you reviewed your income and tax withholdings recently? *YesNoI’d like some help.14. Do you frequently use credit or debit cards for personal purchases? *YesNoI’d like some help.15. Would you like a free financial review to see how CODE can help you manage your money more effectively? *YesNoSubmit
