Financial Wellness Town Hall

Participant Name*

Participant Civilian Email*

Phone Number*

Address (where your gift card will be mailed)*

Street Address City State ZIP Code

Number Dependents Living in Applicant's Household*

Applicant Age*

Military Affiliation*

Servicemembers Rating/Pay Grade (e.g. E-5)*

Servicemembers Rank (e.g. Sergeant or SGT)*

Military Unit Servicemember Most Recently Assigned To*

I was activated as part of the COVID response/relief efforts.*

I have deployed overseas since 9/11*

Location of post 9-11 deployment/activation (does not include training) OR not applicable*

Race/Ethnicity (check all that apply)

American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White

After participating in this Town Hall, do you plan to apply for any of the following benefits? (check all that apply)

Veterans' Bonus
MA COVID 19 Bonus
Veterans Housing Benefits
Veterans Financial Benefits (e.g. VA Home Loan, Tax Exemptions)
College Tuition Waivers
I have already applied for the benefits I am eligible for
I am not eligible for the benefits

How would you describe your overall experience at this Operation Money Wise workshop?*

Check off any of the interest areas that you would like more information about.*

List other interest areas or other specific questions you would like answered by our partners at TD Bank and the State Treasurer's office.

I prefer to be contacted by:

I am requesting a grocery card from:

You are welcome to provide any additional feedback below.

I confirm that I took part in the 75 minute Financial Wellness Forum on November 2, 2022 and that my name appears on the Webex login. I understand a $100 grocery card will be mailed to me within 2 weeks to the address above.

Yes

(Initial Below) I attest that the information above is accurate and true to the best of my knowledge. I can provide proof of my military affiliation with an LES/DD-214/military ID or other acceptable proof if asked. I give Military Friends Foundation permission to share information with their partners at TD Bank, Office of the State Treasurer and other partners to assist with my financial questions.*

Military Friends Foundation

Financial Wellness Town Hall Post Survey November 2022