Element Appointment

Personal Information

Your Name *

Email *

Phone # *

May we text you at this number? *

Yes

No

Are you a member of Element? *

Yes

No

Appointment Purpose

(check all that apply)

Loan Application

New Personal Membership

Improve Credit Score/History

New Business/Organization Account

Join our PEEPs!

List other topics you'd like to discuss during your appointment.

Preferred Appointment Date

Monday - Friday (excluding federal holidays)

Enter Date *

Preferred Appointment Time

Appointment times begin at 8:30 am and end at 4:00 pm ET

Enter Time *

Preferred Appointment Location

Kanawha City - in person

South Charleston - in person

The Element Edge - in person

Zoom - virtual meeting

Your responses will remain confidential, and the information provided will be used solely for the purpose of your money wellness appointment. Thank you for taking the time to complete this questionnaire. Your responses will help us provide you with a more personalized and effective money wellness appointment.

Thank You!

We'll be in touch soon to follow up with your Money Wellness appointment.