Registration Survey - Securing Your Legacy 8/14/26

Securing Your Legacy

Chase Harlem Community Center
55 West 125th Street
New York, NY 10027

Date 8/14/2026
Time: 5:30PM- 8:00PM

Contact Information

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* 1. Full Name

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* 2. Email Address

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* 3. Phone Number (Optional)

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* 4. ZIP Code

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* 5. Borough (Optional)

Brooklyn

Queens

Bronx

Manhattan

Staten Island

Household & Housing Profile

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* 6. Which best describes you?

Homeowner

Renting

Living in a family-owned property

Planning to purchase a home in the next 1–3 years

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* 7. What is your age range? (Optional)

18–34

35–49

50–64

Over 65

Wealth & Asset Baseline

Estate Planning

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* 8. Do you currently have a will or estate plan?

Yes

Not sure

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* 9. Do you have a plan for how your home or assets will be transferred to your family?

Yes

Not sure

Insurance

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* 10. Do you currently have life insurance?

Yes

Not sure

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* 11. If yes, do you feel it is enough to support your family long-term? (Optional)

Yes

Not sure

Investment / Wealth Building

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* 12. Do you currently invest (retirement accounts, stocks, etc.)?

Yes

Not sure

Action & Intent

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* 13. What do you plan to do in the next 3–6 months? (Select all that apply)

Create or update a will

Speak with an estate planning attorney

Purchase or review life insurance

Start or increase investments

Attend a financial counseling session

Learn more before taking action

None of the above

Registration Survey - Securing Your Legacy 8/14/26

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* 1. Full Name

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* 2. Email Address

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* 3. Phone Number (Optional)

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* 4. ZIP Code

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* 5. Borough (Optional)

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* 6. Which best describes you?

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* 7. What is your age range? (Optional)

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* 8. Do you currently have a will or estate plan?

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* 9. Do you have a plan for how your home or assets will be transferred to your family?

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* 10. Do you currently have life insurance?

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* 11. If yes, do you feel it is enough to support your family long-term? (Optional)

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* 12. Do you currently invest (retirement accounts, stocks, etc.)?

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* 13. What do you plan to do in the next 3–6 months? (Select all that apply)

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* 14. How would you rate your knowledge on a scale of 1-5. 5 being the highest.