Contact Contact Please contact us with any questions about our services or products. Connect with us 1 Catharine StreetBelleville, ON K8P 1K8 613-968-6751 ext. 25 1-800-555-5898 ext. 25 lise@liseallininsurance.com Let us know what you feel you need assistance with? REQUEST INFORMATION Prefix (Dr., Ms, etc) Name * Name First First Last Last Email * Phone * Best time to call I / We would like : A financial plan completed at no fee A retirement plan A review of current and alternative investments To invest for our children A life insurance review To receive your annual newsletter Information on seminars I / We would like to be contacted by : No Preference Lise Allin Ted Crago Bernie Tenbult Andrew Maclean Lisa Dwyer Other comments or requests : Please tell us a little about yourself so we can best answer your request : Age Group Under 25 26 to 35 36 to 45 46 to 55 56 to 65 66 to 75 Over 75 Marital Status Single Married or Equivalent Separated Divorced Widowed Annual Income Less than $25,000 $25,001 to $45,000 $45,001 to $75,000 $75,001 to $95,000 $95,001 to $125,000 $125,001 to $250,000 More than $250,000 Approximate Net Worth Less than $10,000 $10,001 to $50,000 $50,001 to $100,000 $100,001 to $250,000 $250,001 to $750,000 More than $750,000 reCAPTCHA If you are human, leave this field blank. SUBMIT NOW