Getting Ahead Interest Form
Thank you for your interest in our Getting Ahead in a Just Gettin' by World investigative group. This group will meet twice per week for 8 weeks for a total of 16 sessions. Individuals in this group will investigate poverty in their own lives and in the community to find realistic solutions to start getting ahead instead of just gettin' by.
Participants will be paid $25 per session (paid weekly). Transportation and childcare assistance is available. Once your application is submitted you will be contacted for an initial interview to determine eligibility. If you have further questions, please contact Amanda Davis at 423-472-4414. We look forward to talking with you more!
SS Number (Last 5 Digits)
Date of Birth
Are you currently working? (mark what applies best)
Yes, full-time (32 hours or more per week)
Yes, part-time (5-31 hours per week)
Yes, hours vary
No, receive unemployment
No, receive disability and/or retirement
No, unable to work
No, looking for work
What is your current household income?
What is your current personal income?
Relationship Status (mark all that apply)
Married and reside in same household
Married and reside in separate household
In long term committed relationship
Do you have reliable transportation to attend this course? (this does not affect your eligibility)
If yes, what type of transportation
Do you have children in your household?
If yes, what are their ages?
Will you need childcare for your children in order to attend?
Yes (Mark even if needed only for some of the classes)
No, I have someone reliable to care for my children
I may but I am not sure at this time
How did you hear about the program? (all that apply)
The Caring Place
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service