Questionnaire If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Name * Zip Code * Phone or Email * Age * 19 or younger20-2930-4445-6566 or older Gender * MaleFemale Ethnicity / Race * WhiteHispanicAfrican-AmericanAmerican IndianAsianMixed Race Approximate annual household income * Less than $15,000$15,000 - $35,000$35,000 - $50,000More than $50,000 Source of income? * EmploymentSocial Security benefitsPensionOther Number of people in household: * Do you: * RentOwn Have you used any of the following in the past 2 years? * Check cashing servicePawn shopPayday loanLoan from family or friendsStudent loanCar loanNone of the above Please check the banking products and/or services that interest you. * Checking/Savings accountSecured Credit CardFinancial EducationSmall Dollar LoanHome Mortgage LoanOther
