Full name Mobile numberSouth African and international formats are accepted. Email address Age rangeSelectUnder 2525–3435–4445–5455–6465+ Employment statusSelectEmployedSelf-employedBusiness ownerProfessionalRetiredOther Main area you would like help withSelectBuilding wealthRetirement planningInvestment planningMonthly investment incomeProtecting my familyLife coverWill & estate planningEducation planningTax-efficient investingReviewing existing investmentsShariah-compliant investingI’m not sure yet

Approximate monthly household incomeSelectBelow R20,000R20,000–R40,000R40,001–R75,000R75,001–R150,000R150,000+Prefer not to say Amount you could comfortably save or invest monthlySelectBelow R1,000R1,000–R2,500R2,501–R5,000R5,001–R10,000R10,001–R25,000R25,000+Currently not saving Funds currently available for a lump-sum investmentSelectNoUnder R50,000R50,000–R100,000R100,001–R250,000R250,001–R500,000R500,001–R1 millionR1 million+ Main financial product currently in placeSelectNone of the aboveRetirement annuityPension / provident fundUnit trustsEndowmentInvestment propertyLife coverDisability / income protectionWillExisting investment portfolioShariah-compliant investments When was your financial plan last reviewed?SelectWithin the last 6 months6–12 months ago1–3 years agoMore than 3 years agoI have never had a financial review Biggest financial priority right nowSelectGrow my capitalCreate an additional monthly incomePrepare for retirementProtect my familyReduce financial uncertaintyPlan my estateSave for my children’s futureReview my current investments When would you ideally like to achieve this goal?SelectWithin 1 year1–3 years3–5 years5–10 years10+ years Approach to investment riskSelectConservative — protecting capital is my priorityModerate — balance between growth and stabilityGrowth focused — comfortable with greater fluctuationsI’m not sure

When would you like to speak to an adviser?SelectAs soon as possibleWithin the next few daysWithin the next 2 weeksI’m only exploring at the moment Preferred contact methodSelectWhatsAppPhone callEmail