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Financial Planning Request

Name

First Name

Last Name

Email Address

Phone Number

(###)

###

####

Spouse's Name (if applicable)

First Name

Last Name

Spouse's Email Address (if applicable)

Type of Assets and Amount

(e.g., Cash, 401k, IRA, etc.)

Type of Debt (if any) and Amount

(e.g., Credit card, student loan, mortgage loan, etc.)

Approximate Salary and Net Worth (combined)

Financial Planning Goals

(e.g., Paying off debt, saving, investing, etc.)

Additional Information

How did you hear about me?

Speaking Request

Name

First Name

Last Name

Email Address

Organization

Proposed Topic(s)

Date/Time of Event

Location of Event

Estimated Number of Attendees (in-person and virtual)

Budget

Additional Information

How did you hear about me?

Media Request

Name

First Name

Last Name

Email Address

News Outlet/Organization

Story/Topic

Date/Time of Interview (if applicable)

Location of Interview (if applicable)

Additional Information

How did you hear about me?

all other inquiries

For all other requests, please use the form below. You can also reach me at roger@lifelaidout.com.

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Subject

Message

Please click the appropriate button below to reach me!

financialplanning

Speakingrequests

Mediarequests

all other inquiries

financial
planning

Speaking
requests

Media
requests