Do you want more information about how to become a part of the community of investors
who are using their investments to help change the world while securing their financial goals? We would be happy to send you more information or
contact you to answer your questions. Please give us a little more information in the space provided below so we can get started.
Contact Information
Name
Email
Address
Phone
Number
So that we can get a little more of an idea about your background, please complete the following survey: (optional)
1. The following issues are of concern to me: 1=Great concern 2=Some concern 3=Little/No concern
Issues:
Quality of products/services
1= 2= 3=
Environment
1= 2= 3=
Employee relations 1= 2= 3=
Military contracting 1= 2= 3=
Alcohol 1= 2= 3=
Tobacco 1= 2= 3=
Gambling
1= 2= 3=
Nuclear power
1= 2= 3=
Animal testing 1= 2= 3=
Genetic engineering 1= 2= 3=
2. I would like to explore opportunities to invest in:
Renewable energy
Organic agriculture & products
Women owned businesses
Fair trade companies
Low income community development
Other
5. I would like more
information on
401 (k)
403 (b)
6. Do you currently work with an investment consultant?
Yes
No
7. If yes, do they offer SRI services for your investments?
Yes
No
8. I would describe my investment style as:
Risk Averse
Risk Taking
Not sure
9.
The value of my current investments is approximately*
Under $10,000
10,000 to $50,000
50,000 to $100,000
100,000 to $500,000
Over $500,000
10. I have been investing for years.
3. What investment services are you interested in?
Portfolio management
Retirement accounts
Financial planning
College planning
Non-profit services
Insurance services
Other
4. At present, which of the following investments do you own?
Stocks
Bonds
Mutual Funds
Insurance
Other
* Please respond only if you feel comfortable: but be assured that all supplied
information will be kept in confidence
