FILL OUT THIS FORM FOR A CHANCE TO WIN AN IPAD MINI OR KINDLE!!
Zip Code: ___________
AGE: ________
Household Size: _________ Gender: Female/ Male
Annual Household Income (please circle)
$1,000 -$9,999
$40,000-$49,999
$10,000-19,999
$50,000 - $59,999
$20,000-$29,999
$60,000 or more
$30,000-$39,999
On a scale of 1 to 5 please rate the following (1 lowest, 5 highest):
This session was a good use of my time.
The presenter/speaker was effective.
The information presented was useful.
The time and location of the session were convenient.
My financial understanding has increased as a result of this session.
I am likely to change my money behaviors as a result of this session.
I am likely to seek out additional Money Smart financial resources
and/or tools as a result of my participation in this workshop.
1
1
1
1
1
1
1
2
2
2
2
2
2
2
3
3
3
3
3
3
3
4
4
4
4
4
4
4
5
5
5
5
5
5
5
How did you learn about this Money Smart event (circle all that apply)
*TV/RADIO
*EMAIL
*FACEBOOK
*SNAPCHAT
*MONEY SMART WEBSITE
*WORD OF MOUTH
*NEWSPAPER
*TWITTER
*INSTAGRAM
*OTHER: __________
HAVE YOU EVER ATTENDED A MONEY SMART EVENT IN THE PAST?
*PRINTED FLYER
*WORD OF MOUTH
YES
NO
Drawing Contact Name (Optional):_________________ Contact number (Optional):______________
Use your smartphone to check out more Money Smart KC events near you, or visit:
Money Smart KC Calendar of Events: www.moneysmartkc.org/events
Session Name: __________________________ Facilitator(s): ___________________ Date: __________