East Oakland SuSu Lending Circle Program: 2020 Cohort Questionnaire
Thank you for signing up for the East Oakland SuSu Lending Circle Program. Please complete this questionnaire to participate in the program by February 20, 2020.

Your answers to these questions help East Oakland Collective track the success of the East Oakland SuSu Lending Circle Program. They also help us show success to funders and other supporters through facts and figures about how the program helps participants overall, as a group. We won't sell or even share your specific answers, results, or personal details with anyone else, and we won't use them to decide whether you can take part in the lending circle or any of our other programs.

We use Esusu, an online service, to run the lending circles. If you have questions about Esusu and your personal information, have a look at their website, https://esusu.org. In particular, their terms and privacy pages spell out what information they share with credit rating bureaus, and how.

For questions or concerns, contact us at info@eastoaklandcollective.com.
Participant Info
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
What is your zip code? *
Your answer
What is your age? *
What is your gender? *
What is your ethnicity? (Please select all that apply.) *
Required
How many children are you parent or guardian for and live in your household (aged 17 or younger only)? *
Which of the following categories best describes your employment status? *
What is your income level? *
Financial Wellness
What is your current credit score? *
Do you have a personal budget? *
Have you used a pawn shop or payday loan service in the past 3 months? *
During the last 6 months, was there a time when you and your family were not able to pay: *
Required
Which of the following comes closest to your financial situation over the last 6 months? *
How useful are financial institutions to you (banks, credit unions)? *
Would an emergency put you in financial hardship for the month (i.e. flat tire, illness, etc.)? *
How confident are you in setting short and long term financial goals? *
Not confident
Very confident
How confident are you in saving money regularly? *
Not confident
Very confident
How confident are you in using a spending plan to track your income (money coming in) and expenses (money going out)? *
Not confident
Very confident
How confident are you in paying bills on time? *
Not confident
Very confident
How confident are you in creating a personal budget? *
Not confident
Very confident
Program Survey
Have you ever participated in a lending circle before? *
What is your primary savings goal? *
What lending circle amount are you interested in? (Note: the amount will be deducted from your bank account by the Esusu platform each month for the duration of the program.) *
Lending circle cohorts will be formed based on lending amounts, but feel free to indicate if there is a friend, family member, or community member you would like to be in a cohort with.
Your answer
Were you referred to this program? If so, by whom?
Your answer
What are your expectations for the program? *
Required
Are you able to attend the orientation on Thursday, February 20, 2020, 6:30 PM at EOC's office? Orientation is required as the lending circles will be formed, but please advise in advance if you are unable to make it. *
Please indicate if there is a need for financial assistance for travel and/or legal documentation. (Note: We have limited funds to offer, so please only indicate if you are sincerely financially vulnerable)
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