Women's Money Matters
Getting to Know You Survey

Please select your language.

This 6 section enrollment survey enables us to learn more about you, your education, employment, current financial background, and confidence level about personal finance. The information helps our team match you with a great coach and effective curriculum to best support you and your goals. We understand this is very personal and encourage you to take your time answering each question.

This survey will take approximately 15 minutes to complete.

Life Launch

Please select the Life Launch program you wish to enroll in.

WEDNESDAYS - Start: 1/29/25, 6:00-7:00pm ET, Evenings
Life Launch (English/Virtual) REQUIRED

Program ID

Name of program partner:

General Information

Primary Language

REQUIRED

Other Primary Language

REQUIRED

Do you speak an additional language?

YesNo REQUIRED

Other Secondary Language

REQUIRED

Ethnicity/Race (Check all that apply.)

Asian/Asian American/of Asian descentBlack/African American/of African descentHispanic/Latino/Latina/Latinx/of Latinx or Spanish-speaking descentMiddle Eastern/North African/of North African descentMulti-racial or multi-ethnic (2+ races/ethnicities)Native American/American Indian/Alaska Native/IndigenousOther - please specifyPacific Islander/Native HawaiianWhite/of European descent REQUIRED

Other - please specify

REQUIRED

Dependents
Enter the number of dependents you have for each age group. If you don't have dependent(s), leave 0 for all.

Infant - 5 years	6 - 13 years	14 - 18 years	18+ years
REQUIRED	REQUIRED	REQUIRED	REQUIRED

Education and Employment

Financial Futures: Education and Employment

If able to attend school, please share the level of education completed.

REQUIRED

Other Level of Education

Please select which best describes your current employment status.

Please select your current industry.
This question is meant to collect general industry data and not exact title or company information.

Other Industry

Job Title

Do you have a bank account?

YesNoREQUIRED

My estimated monthly net income is . (Net income is your take home pay after taxes)

Net income is your take home pay after taxes.

In the past 3 months, I have saved .(Enter "0" if not applicable.)

What is your most significant financial challenge?

Life Launch: Education and Employment

Please share your current education status

Finances

Do you have a bank account?

YesNo

In the past 3 months, I have saved . (Enter "0" if not applicable.)

My estimated monthly net income is . (Net income is your take home pay after taxes)

Net income is your take home pay after taxes.

Confidence

In the past month, how confident have you felt:

Financial Well-Being (only answer if you are age 18 or older)

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. We will ask you to complete this survey again at the end of the program to help us measure changes in our community’s financial well-being.

My financial well-being score is. (Your score should be between 0 - 100.)

REQUIRED

About You

About You

What is your goal with enrolling in this program?

How would people who know you best describe you?

Can you share any special interests or details about yourself that will help us match you with the perfect coach?

Describe one thing you are especially proud of in your life.

What is the most significant change you've faced in the last two years?

Do you have an adult in your life who you go to for advice about financial matters?

YesNo

Have you taken a financial education class in school?

YesNo

Participant Incentives!

As a participant in our programs, there may be opportunities to receive CASH incentives. This includes $75 upon graduation and submission of your graduation survey. Other opportunities may be shared with you during the program.

Please select your preferred payment method:

CashAppPaypalI would prefer a gift card

Please enter your username for the selected payment method

Please re-enter your username for the selected payment method

Thank You for Completing This Survey!

May we share this survey with out coach?

YesNo

As a participant, you receive one-on-one support from a volunteer coach. In addition to attending a series of workshops with your coach, you and your coach can have individual follow-up discussions - either in person or virtually. We request you contact your coach at least 24 hours in advance, if possible, if you cannot make a scheduled workshop or meeting.

Please sign below to indicate you understand and accept the responsibilities required of participants in this program.

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:

Release Form Choice

I hereby acknowledge and provide consent for Women’s Money Matters to access my credit files with the credit reporting agencies under the Fair Credit Reporting Act (FCRA) and to exchange the information about you to such national credit reporting agencies in order to to verify your identity using the information you provided (including but not limited to name, address, date of birth, email address, phone number) and receive a Credit Score “bucket” (not an exact credit score) for the purposes of program improvement, future support and coaching opportunities for graduates.

I do not provide consent for Women’s Money Matter to access my credit files in any capacity.

Upon completion of this survey, we will follow up with an additional opportunity to tell us more about your life and what brought you to Women’s Money Matters. This information will only be shared with our team and your coach. Please know that this question is optional.

Media Release Form

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

I hereby acknowledge and agree that my image and/or voice may be used and/or reproduced in connection with my participation in the Women's Money Matters program. I acknowledge and agree that meetings held virtually may be recorded and still photographs of the virtual meetings may be taken. I grant Women's Money Matters and its business partners all rights to the recording, taping, reproduction, copyright, display, distribution, redistribution, and transmission of my image and/or voice, any chat/text responses, and answers to any polling questions and waive all claims, including but not limited to privacy and compensation claims, I may have against Women's Money Matters and its business partners in connection with such use. I further waive all claims against Women's Money Matters or its business partners that I, my agents, heirs, or assigns may possess, now or in the future, in connection with such use including restrictions on waivers of future claims.

I do not agree to allow Women's Money Matters to use my image and/or voice in any capacity in connection with my participation in a Women's Money Matters program(s) and/or events.

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.

Release Form Choice

I hereby acknowledge and understand that Women's Money Matter Coaches are not financial advisors.

Arabic	Bengali	Cape Verdean	Chinese	English
French	German	Haitian	Italian	Japanese
Khmer	Korean	Lahnda	Malay	Marathi
Persion	Portuguese	Russian	Spanish	Tamil
Telugu	Turkish	Urdo	Vietnamese	Other

	Very Confident	Somewhat Confident	Not Confident	I don't know
Managing your money?
Planning for your financial future?

Women's Money MattersGetting to Know You Survey

General Information

Education and Employment

About You

Women's Money Matters
Getting to Know You Survey