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: 12:00PM - 2:00PM

Contact Information

Question Title

1. Full Name (Required.)

Question Title

2. Email Address (Required.)

Question Title

3. Phone Number (Optional)

Question Title

4. ZIP Code (Required.)

Question Title

5. Borough (Optional)

Brooklyn

Queens

Bronx

Manhattan

Staten Island

Household & Housing Profile

Question Title

6. Which best describes you? (Required.)

Homeowner

Renting

Living in a family-owned property

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

Question Title

7. What is your age range? (Optional)

18–34

35–49

50–64

Over 65

Wealth & Asset Baseline

Estate Planning

Question Title

8. Do you currently have a will or estate plan? (Required.)

Yes

Not sure

Question Title

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

Yes

Not sure

Insurance

Question Title

10. Do you currently have life insurance? (Required.)

Yes

Not sure

Question Title

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

Yes

Not sure

Investment / Wealth Building

Question Title

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

Yes

Not sure

Action & Intent

Question Title

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

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

Question Title

* 1. Full Name (Required.)

Question Title

* 2. Email Address (Required.)

Question Title

* 3. Phone Number (Optional)

Question Title

* 4. ZIP Code (Required.)

Question Title

* 5. Borough (Optional)

Question Title

* 6. Which best describes you? (Required.)

Question Title

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

Question Title

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

Question Title

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

Question Title

* 10. Do you currently have life insurance? (Required.)

Question Title

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

Question Title

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

Question Title

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

Question Title

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

1. Full Name (Required.)

2. Email Address (Required.)

3. Phone Number (Optional)

4. ZIP Code (Required.)

5. Borough (Optional)

6. Which best describes you? (Required.)

7. What is your age range? (Optional)

8. Do you currently have a will or estate plan? (Required.)

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

10. Do you currently have life insurance? (Required.)

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

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

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

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