Financial Empowerment Scholarship Program

House of Hope is offering our financial empowerment scholarship to working, single mothers!  Our goal – to increase financial tools and wellness!
As a whole, House of Hope provides single mothers and women aging out of foster care with individualized support and transitional housing to achieve permanent homes and self-sufficiency. Financial empowerment can be felt throughout families and generations. We have found when women OWN more of their financial awareness, HUGE things happen! We are excited to offer this program.
Join us for one hour, five weeks in a row to increase your financial wellness and earn $500 to go toward – housing, transportation or health!
We look forward to meeting you!

General Information

Name *

First

Last

Email *

Date of Birth *

Current Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

Alternative Phone Number

What is the name of your employer and what department do you work in? *

Are you a single mother (with children in your care) wiht a current lease/mortgage in only your name? *YesNo

Children

1. First Name

1. Last Name

1. GenderFemaleFemaleMaleNon-BinaryPrefer Not to Say

1. Date of Birth

2. First Name

2. Last Name

2. GenderFemaleFemaleMaleNon-BinaryPrefer Not to Say

2. Date of Birth

3. First Name

3. Last Name

3. GenderFemaleFemaleMaleNon-BinaryPrefer Not to Say

3. Date of Birth

4. First Name

4. Last Name

4. GenderFemaleFemaleMaleNon-BinaryPrefer Not to Say

4. Date of Birth

5. First Name

5. Last Name

5. GenderFemaleFemaleMaleNon-BinaryPrefer Not to Say

5. Date of Birth

6. First Name

6. Last Name

6. GenderFemaleFemaleMaleNon-BinaryPrefer Not to Say

6. Date of Birth

Driving Information

Do you have a driver's license? *

• Yes
• No

Do you own a car? *

• Yes
• No

Do you have car insurance? *

• Yes
• No

Is there something from keeping you from getting your own car? *

Is there something keeping you from having car insurance? *

Additional Information

Highest level of education (GED, High School, College) *Some High SchoolGraduated High SchoolHISETSome CollegeGraduated College

What are your goals for the future? *

Is there anything specific you are hoping to gain from this empowerment program? *

Agreements

I, voluntarily allow release of information with my employer in order to verify employment and acceptance into this scholarship program. (Entering your name/date constitutes a signature) *

I understand that I will need to complete all the steps outlined in the program in order to receive the scholarship that will be paid directly to housing, transportation, or health related bills. (Entering your name/date constitutes a signature) *

Photographs might be taken during or at the conclusion of the scholarship program. This is meant to serve as a release if your photo is taken individually or as part of a group during the program. I, voluntarily, give permission to use my likeness in a photograph or other digital reproduction in any and all of its publications, including website entries, without payment or any other consideration. I waive the right to inspect or approve the finished product, including written or electronic copy, where in my likeness appears. (Entering your name/date constitutes a signature) *

Lastly, if you know, now, where you would like the funds to be released to at the completion of the Financial Empowerment Scholarship Program; please give us the necessary information below. Including, if it is * Housing – Name of landlord, address to mail payment, the address of the housing unit being paid for, and a copy of the lease agreement. * Transportation – Name of agency to be paid, account number assigned to the bill, name associated with the account, copy of billing statement. * Health – Name of agency to be paid, account number assigned to the bill, name associated with the account, copy of billing statement. If you do not know where you want your scholarship to be paid to yet, you may complete this question at a later time.

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