Hi! Thanks for giving us a bit of your time. This won't take two minutes! :)

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* 1. When were you born?

Date

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* 2. What is your AXA policy email address? (we just want to make sure it's you)

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* 3. We'd love to know more about you. What are the most significant events that happened to you for the past 12 months?
(Tick all that applies)

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* 4. What are your short term goals and which ones do you think would be your priority for the coming year? 
(Tick all that apply)

Thank you for answering our questionnaire! We're looking forward in better serving you. 

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