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Register for Budgeting Basics ONLINE, Tuesday, May 12, 2020, 6:30 - 7:30 p.m.
If you require accommodations to participate in this class, please contact Kelley Glidden at 207-621-3436 or kelley.glidden@maine.edu

Thank you for providing the following information. Your name and contact information will not be shared. Aggregate data is used for the purposes of reporting to our funders and measuring the success of our programs.

All fields are required on the registration form. Please contact  Kelley Glidden at 207-621-3436 or kelley.glidden@maine.edu if you prefer a paper copy or have any questions. If you have taken a class with NVME recently, contact the trainer. Your registration information may already be on file.

You may be contacted in the future to provide feedback on your experience with NVME.

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Name - First *
Name - Middle
Name - Last *
Date of Birth *
MM
/
DD
/
YYYY
Address *
City *
State *
Zip *
Email *
Phone number *
Alternate phone number
How did you hear about us? *
Sign me up for the email news about our programs? *
Required
Gender
If you would like the opportunity, we invite you to say more about your gender identity here:
If you are of Franco-American heritage, please check here. *
Required
If you consider yourself Hispanic or Latino, please check here. *
Required
In addition, check one or more of the following racial categories to describe yourself. *
Required
If you chose other above, please list here.
Work Status *
Required
I have a disability that limits my work *
Required
I receive SSI, SSDI, or veterans disability? *
Required
I am a veteran, active duty military or reservist *
Required
I receive unemployment insurance (UI)? *
Required
I am looking for work *
Required
Education Information *
Required
Are you currently enrolled in school? *
Required
If you are currently a student, what kind of program are you enrolled in?
Major field of study?
Are you a University of Maine Augusta student? *
Number of people in your household including you *
Total  monthly Income for your household (from all sources) *
Health Insurance coverage (choose one) *
Are you the Head of Household? *
Are you a single parent? *
My household receives food stamps. *
My household receives TANF. *
I have savings. *
I have retirement savings. *
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