Gervonni Cares Financial Literacy Course Registration Form

Learner Pre-Registration Form

Fill out this form carefully for pre-registration. Each class meets twice a week for (1) hour. Loaner laptops are provided for class ONLY. If you take all classes marked below with an *asterisk consecutively, you will be able to keep laptop provided as a donation from our organization upon completion of classes. This form is for informational purposes only. It does not promise or guarantee acceptance into either of our GCI financial literacy classes. You may call us at 602-675-9589 with any questions or concerns.
Learner Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you 18 years or older?*
If 18 or older, please provide date of birth.*
Gender
Learner E-mail*
example@example.com
Mobile Number*
Are you employed?*
If so, Full-time or Part-time*
What is your estimated annual income?
Do you receive any state government assistance?*
Do you own a computer or laptop?
Please select from our free financial literacy courses below the ones that interest you most.

Economic & Government Influences*Credit Profile Building & Repair*Savings, Expenses & Budgeting*Loans & Debt*Financial Psychology (mandatory)Debt Elimination WorkshopNew Home Buyer WorkshopRisk Management & Insurance
Are you available approximately 2 -3 hours per week for scheduled classes via in person, or Zoom?
Why do you feel financial literacy is important?
By clicking submit application below, you have read and understand that the information you provided is truthful and you do not hold Gervonni Cares, Inc. or it's affliates responsible for your finances. In addition, you understand that GCI is neither a CPA, Attorney, Financial institution or Financial advisor. We are a 501(c)3 nonprofit organization providing classes for informational purposes only.
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Learner Pre-Registration Form