Online Request
Individual Saving

*First name :

*Last name :

*Phone :

*City :

What kind of coverage are you interested in ?TFSARRSP-RRIFLRSP-LIRIAHBP-RESP-RDSP-LLPNon-registered SavingsLife AnnuitiesRetirement PlanningFinancial PlanningMortgage Broker Referral

*Are you or have you ever been one of our clients ?YesNo

When do you want us to call you ?MondayTuesdayWednesdayThursdayFriday

Between 8h30 a.m. and 12h00 p.m.Between 1 p.m. and 5 p.m.

Email:

I hereby authorize Lussier Dale Parizeau to send me information about its products and services by email (I will be able to modify my permission at any time):

Special offers, saving opportunities, contestsYesNo

Newsletter (general information and advice about the company and products)YesNo