Name:         
  Address:    
  City:         State/Province: 
  Zip Code:   
  Email:      
  Home Phone:   
  Work Phone: 
  Your Age:     Spouse's Age: 
  

  Which best describes your overall attitude towards investing and risk?  
  I am generally willing to accept:

     Wide price fluctuations in return for maximum long-term gains
     Moderate price fluctuations for conservative gains
     Virtually no price fluctuations for a guarantee of principal and income

  What is your employment status? Full TimePart TimeRetiredUnemployed

  Your Occupation: 
  Your Spouse:     
  Desired Age of Retirement: 
  Your Spouse:               

  Gross household income last year? $25-50,000$50-100,000$100-150,000$150-250,000$250,000 & Above

  My Federal Tax Bracket is: 15%28%31%36%39.6%
			     
  My State Tax Bracket is:   15%28%31%36%39.6%

  General awareness level of stock/bond market activites: HighMediumLowVery Low

  Of the mutual funds you own, do you spend or reinvest the earnings?
     Spend    Reinvest

  I actively switch or reallocate among my portfolio...
  at least OneTwoThreeOver Five times per year.

  Your favorite money managers are: No PreferenceAIMAllianceAlgerAmerican CapitalAmerican CenturyBabsonBergerBlanchardCalvertCappiello RushmoreCohen & SteersColonialDavisDean WitterDodge & CoxDreyfusEaton VanceEnterpriseEvergreenFederatedFidelityFortisFoundersFranklinGT GlobalGabelliGuardianHartfordHeritageIAIIDEXInvescoJanusKaufmanKemperLindnerLoomis SaylesMFSMerrill LynchMontgomeryMutual SeriesNationwideNeuberger & BermanNicholas ApplegateNorwestNuveenOakmarkOberweisOppenheimerPBHGPIMCOPainewebberParnassusPiper JaffrayPrudentialRobertson StephensRushmoreSaloman BrothersSchwabScudderSeligmanSequoiaSmith BarneyStein RoeStrongTempletonThird Ave ValueTweedyThornburgUSAAValue LineVan EckVanguardVontobelWaddell & ReedWarburg PincusWeiss, Peck & GreerYacktmanZweig  

  Which investment newsletters/periodicals do you subscribe to: 
    NoneBusiness WeekFinancial WorldKiplingerPhillips PublishingSmart MoneyMoney MagazineU.S. News & World ReportWall Street JournalOther

  What type of mutual funds do you generally prefer?            
    Aggressive GrowthGrowthGrowth & IncomeIncome OrientedSector / SpecialtyOther

  Are you contributing to Qualified Retirement Plan?            
     Yes    No 
  
    If so, what type: 
    401k403(b)IRARoth IRASARSEPSEPSimple IRASimple 401kProfit Sharing
 
  What best describes your current level of satisfaction with your mutual fund 
  holdings:
    Not SatisfiedSomewhat SatisfiedVery SatisfiedIndifferent  

  How do you select your mutual funds?
    Technical / Fundamental AnalysisBottoms Up ApproachTops Down ApproachPrior Performance
						      
  Who do you rely upon for financial input or advice? SelfCPAAttorneyInsurance BrokerInvestment BankerFee-only PlannerOther
						      
  Your primary concers are:                           Retirement PlanningTax ReliefAsset AccumulationCurrent IncomeEstate PlanningCollege FundingDebt ConsolidationOther

  Approximate value of current mutual fund holdings:
     5-10K    10-25K    25-50K    50-100K    100-250K    Over


  Additional Comments/Questions: