Intake form

Name *

Email address *

What is your current employment status?

What is your primary reason for seeking financial education?

Please select at least one option.

Budgeting

Debt management

Saving for a goal

Understanding credit

Investing

What type of financial tools are you interested in?

Please select at least one option.

Budget tracking

Expense management

Savings tools

Debt reduction tools

Investment tracking

Have you previously participated in any financial education programs?

What is your preferred method of learning?

Please select at least one option.

Interactive modules

Videos

Webinars

In-person workshops

Reading materials

What challenges do you face in managing your finances?

Which resources would you find most helpful?

Please select at least one option.

Personal finance coaching

Workshops

Online resources

Community support groups

Mobile apps

What is your age group?

What is your highest level of education completed?

Additional questions or comments

FREE (Financial Reintegration & Education Empowerment)