C.A.R. Program Qualification Form

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Please answer ALL questions truthfully, missing information will not be considered. You will receive a reply within 5 business days.

Name *

Please provide your email address

Do you currently have a valid drivers license?

Yes

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Does anyone living in your household own a vehicle?

Yes

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Do you own a vehicle that is in need of repair?

Yes

Clear selection

Are you willing to attend 6 manditory classes?

Yes

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Are you willing to do community service?

Yes

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Do you attend Ginghamsburg Church or other Ginghamsburg Campuses?

Yes

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What type of vehicle would you prefer?

2 door car

4 door car

van

pick-up truck

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Can you drive a stick shift vehicle?

Yes

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Address *

City, State and Zip Code *

Phone number

What is the best way to contact you during normal business hours?

US Mail

Phone call

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Daytime phone number

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