Member Questionnaire

Member Questionnaire

1. Please provide us with your current contact information to ensure that our records are complete and up to date (including email address):
2. What is your preferred method of contact from Assured Life Association?:



3. What is your age?:








4. How long have you been a benefit member of Assured Life Association (a benefit member is a person age 18 or older who has been issued and currently owns an inforce life insurance, Medicare supplement insurance or annuity certificate issued or assumed by the Society)?:






5. What is the highest level of education you have completed?:








8. How long have you been using the internet?:







9. Do you volunteer in your community?:



 
 
 
 
 
 

11. Do you donate money to charity each year?:



13. Have you used Assured Life’s matching charitable giving program for your donations?:




14. Assured Life Association has 4 national member service campaigns. Do these campaigns appeal to you? Check all those that appeal to you.:





16. Would you be interested in learning about the Committees of Assured Life Association and volunteering to serve on a committee?:

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Facts on Aging

Per the Arthritis Foundation, knee replacement surgeries have increased by 188 percent over the last 10 years in Americans aged 45–64. These surgeries are not easy procedures, either. They require weeks of recovery time, and some patients report having residual pain for as long as a year after the surgery. 
Arthritis Foundation

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