Getting to Know You Survey

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Welcome! Please find below your survey for enrollment in a Women's Money Matters program. This survey will help us learn more about you and gain a better understanding of your financial needs.  This information will help us match you with a compatible coach and give us a sense of the financial topics you are interested in to ensure that your experience is as relevant and useful to you as possible.

It will take approximately 15 minutes to answer the questions and we ask that you answer all questions. There are no right or wrong answers. All information is used solely by Women's Money Matters.

How did you hear about us?





Participant









     



                                                                                                                                                               




We will be mailing out a graduation certificate and gift at the end of the program. Please be sure your mailing address is correct. 













Enter the number of dependents you have for each age group. If you don't have dependent(s), enter 0 for all: 
Infant - 5 years
14 - 18 years
18+ years 6 - 13 years


About You







What days and times are best for you to meet with your coach? (Check all that apply) 
Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Sundays
Employment




Page 2

Financial Institutions and Services











Finances


 My average monthly income is $
 per month.

I was able to save $
of it (enter zero if not applicable).










In the past 3 months, have you: (Check all that apply)
Always Often Sometimes Rarely Never N/A
Credit






Page 3

Confidence
How confident do you feel in the following situations? 
Very Confident Somewhat Confident Unsure  Not Confident 







Community

Financial Well-Being
Please visit https://www.consumerfinance.gov/consumer-tools/financial-well-being/ on a new tab, and answer the requested questions. At the end of the page, click "Get my Score" and record the number generated below.

Life Launch Program



Please check the boxes that best describe your plans regarding each of the following educational options:
Planning to attend Considering I don’t see myself there I don’t have enough information

Page 4

Thank You for Completing This Survey!


Participant Incentives
As a participant in our programs, there may be opportunities to receive CASH incentives. This includes $25 upon graduation, and $50 upon submission of your graduation survey. Other opportunities may be shared with you during the program. In order to facilitate this payment, please provide your payment method of choice:



Media Release Form
We hope to be able to celebrate the successes of our programs and participants with a wider audience, sharing photos and stories on social media and also with our supporters. Please let us know if you would be okay with allowing us to use your media to spread the word about our programs, by choosing one of the options below:  

Disclaimer: Coaches Are Not Financial Professionals
The information provided by our coaches is intended for general guidance and support purposes only. Our coaches are not licensed financial professionals, and they do not provide financial, investment, tax, or legal advice. The coaching services offered by our team are designed to assist you in setting and achieving your personal and financial goals. We do not make specific financial recommendations or endorse any particular financial strategies or products.

It is important to consult with a qualified financial advisor, accountant, or attorney before making any financial decisions, investments, or legal arrangements. Our coaches are not a substitute for seeking professional advice tailored to your unique circumstances. Any discussions or interactions with our coaches are for informational and motivational purposes. We do not guarantee specific financial outcomes, and the responsibility for your financial decisions remains with you.

While our coaches are committed to providing you with the support and encouragement you need to work towards your goals, it is crucial to exercise your own judgment and consult appropriate experts when necessary. Your financial well-being is a personal matter, and we encourage you to take all necessary precautions when making financial decisions.

Credit Score "Bucket" Release Form

We are always striving to provide the best possible programs to help our participants meet their long-term financial goals. One way we do this is by measuring the impact of our programs. Specifically, it is helpful for us to understand our participant credit scores and the impact our program has on them. 


We respectfully ask your permission to collect your general Credit Score “buckets” (e.g., score of 500-550) and measure how it changes over time.


Our number one priority is privacy. This data (general Credit Score bucket and your personal identifiable information) will be held securely by Women’s Money Matters, and will not be shared in any non-anonymous capacity outside of the organization. Additionally, in no way will the data collection have any impact on your credit score. Let us know if you would be okay with us collecting your general credit score information for the purposes of our program quality measurement and offering additional support:  


If you selected Answer Choice #1, please enter the following information: