Investor Survey

Investor Survey

Name *

First

Middle

Last

GenderMaleFemale

Marital Status

• Single
• Married
• Divcorced
• Widowed

Number of Dependents

• 0
• 1
• 2
• 3
• 4
• 5+

Date of Birth (mm/dd/yyyy)

Email *

Are you a U.S. Citizen or U.S. Permanent Resident (Green Card Holder) *

• Yes
• No

Home Address

Phone Number(s)

Employment InformationEmployed by AnotherSelf-EmployedRetiredUnemployedStudentHome Maker

Financial Information - Investment Objectives (check all that apply) *

• Preservation of Capital
• Income
• Growth
• Trading for Profits
• Speculation
• Hedging
• Don't Know

Financial Information - Estimated Net Worth (in USD) *

• 0 - 249,999
• 250,000 - 499,999
• 500,000 - 999,999
• 1,000,000 - 1,999,999
• 2,000,000 - 4,999,999
• 5,000,000 +

Financial Information - Annual Net Income (in USD) *

• 0 - 149,999
• 150,000 - 249,999
• 250,000 - 499,999
• 500,000 +

Financial Information - Total Asset (in USD) not including primary residence *

• 0 - 999,999
• 1,000,000 - 2,099,999
• 2,100,000 +

Investment Experience - Stock (Yrs)

Investment Knowledge Level - Stock *

• Extensive
• Good
• Limited

Investment Experience - Bond (Yrs)

Investment Knowledge Level - Bond *

• Extensive
• Good
• Limited

Investment Experience - Options (Yrs)

Investment Knowledge Level - Options *

• Extensive
• Good
• Limited

Investment Experience - Futures (Yrs)

Investment Knowledge Level - Futures *

• Extensive
• Good
• Limited

Investment Experience - Forex (Yrs)

Investment Knowledge Level - Forex *

• Extensive
• Good
• Limited

Name

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