CEVAW-LSQ - Carey Vandenberg

Lifestyle Questionnaire

1. Name

2. Email

3. How old are you and what is your marital status?

4. When you aren't working how do you spend your leisure time?

5. What are some of the things that you want to achieve / do over the next year, 5 years, 10 years, and 10+ years?

6. If money was no object, what would be the first 5 things that you would buy, do, embark on?

7. If you could work at any other job rather than the one that you have, what would it be?

8. I would like to retire when I am

9. If retiring at the above stated age isn't workable would your choice be to live on less money or retire at a later date?

10. What will you miss most about the job that you have today?

11. What is your definition of "retirement"? Write down what it will look like I.e. Where will you be living, what kind of housing etc.

12. What do you expect to be doing in "retirement"? (list all of the activities you can think of and their frequency - be specific!)

13. If you were retiring today how much spendable (after-tax) income do you think you would need?

14. Are you expecting an inheritance that would supplement your current financial position?
If so, will that amount be: a) under $100,000 b) $100,000 - $500,000 c) $500,000 to $1 million d) over $1 million?

15. How important is it to you that an "estate" be left to your children (if applicable)?

16. What are your children's ages currently (if applicable)?

17. If you have school age children, which of the statements comes closest to your thoughts on paying for post secondary education?
a) They are on their own b) They pay 1/2, I'll pay 1/2 c) I'll cover most of everything for local education d) The skies the limit!

18. What are your parents' ages?

19. If they are no longer with you, until what age did they live?

20. My biggest concern / hurdle right now is........" (doesn't have to be related to money)

21. My biggest fear right now is......

22. Over the last 5 years what would you have done differently in your life? (doesn't have to be related to money)

23. If you had a financial advisor / planner previously what could he / she have done better? What did they do well?

24. How can I make the most valuable contribution to your life today?