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Fee Waiver Application
My goal is to keep you out of court and build your conflict resolution skills. Your feedback will help me determine if I have met that goal and, if not, what I can improve.
Please take a few minutes to complete this short survey.
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Email
*
Your email
Your Full Name
*
Your answer
Your prior year's gross income from your income tax return
*
Your answer
Your current monthly income
*
Your answer
Your current monthly expenses
*
Your answer
Your favorite coffee shop
*
Your answer
Average times you visit that coffee shop each week.
*
Less than 1 time
1-2 times
3- 5 times
Almost daily
Your favorite restaurant
*
Your answer
Your guilty pleasure?
*
Your answer
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