1x1 Financial Coaching Application
Financial Coaching is free and confidential. It is brought to you by Arlington and Alexandria's Virginia Cooperative Extension (VCE) Master Financial Education Volunteers. Coaching sessions are based on one's needs; coaches help with budgets, debt, answer financial questions, and provide helpful resources.
For more information, please visit
If you have any questions, please contact Aisha Salazar, VCE Family & Consumer Sciences Agent, at
Goals you want to focus on (debt, retirement, budget, etc.). Try to be specific. You can select more than one goal.
Pay off Debt
Pay for school
Build Emergency Fund
Improve Credit Score
Recovery after Identity Theft/Financial Scams/etc.
Purchase a car
Purchase a house
Learn about money management
Financial hardship due to Covid-19
Where do you live
Family Situation (Married, Single, Children, etc, Other dependents)
Monthly income for client and any spouse
Housing situation (Rent, Own/Mortgage)
Debt/Credit (Types, Amounts Owed, Interest Rates, Monthly Payment Amounts (Late/On Time), Credit problems?). Answer to the best of your knowledge.
Head of Household?
Race & Ethnicity
American Indian or Alaska Native
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
Please add any other information you would like to provide.
Financial Coaching Agreement. Please read and sign. I understand that all my financial information will be confidential. My coach is my financial educator and cannot give me legal or financial advice, but can present me with resources, strategies and encouragement during coaching sessions. I understand that my coach will not make decisions for me or make contact with creditors or others on my behalf. Making decisions and taking action will be my sole responsibility. I understand that as a participant to this pilot program I will not receive legal advice or professional financial services. My coach will be there to support and encourage me during the term of the program. Ultimately, I am responsible for my actions. Neither Virginia Cooperative Extension (VCE) or Financial Coach will be held liable for any financial decisions I make as a result of this program. Please sign your name below.
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