Are you an older American with thoughts on work or retirement?
Business Insider wants to speak to older Americans who are still working or looking for work. Note: We won't publish any part of your submission without contacting you first.
Sign in to Google to save your progress. Learn more
What is your age? Please type in a number. *
What describes your employment status? *
What is your job (current or former)? *
Are you motivated to work because of financial reasons? *
Required
If you're not retired, do you plan on retiring?
Clear selection
Briefly, what are some of your major regrets in life? 
What do you wish people knew about working later in life? *
What is your first and last name? We request that all respondents be comfortable with having their full names published.
 *
What is your cell phone number (preferred) and/or email address?
 *
If we decide to reach out about your story, would you be comfortable being photographed? *
If we decide to reach out about your story, would you be comfortable appearing in video?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Business Insider.

Does this form look suspicious? Report

Google Forms