Updated - Free to Save Program Application and Eligibility Form

  • Free to Save Program Application and Eligibility Form

  • The Free to Save Program offers three services:  Financial Literacy Classes, 1:1 Coaching and Asset Savings & Purchase. You must be at least 18 years old and be a resident living in Lancaster or Saunders Counties Nebraska to be eligible for this program. Eligible participants must also meet income (200% of poverty guidelines) and net worth (less than $10,000) requirements. The Free to Save Matched Savings Program is not intended to address immediate needs.  

    Financial Literacy Classes are six weeks of classes that meet once per week, for two hours. Once completed you are eligible to continue with six months of 1:1 Coaching.

    The Asset Savings & Purchase portion of this program provides a 4:1 savings match for the following assets:  first time home, vehicle, post-secondary education and small business start-up or expansion. Individuals are only eligible to participate in the Asset Saving & Purchase portion one time. The waitlist for the Asset Saving & Purchase portion is fluid, based on applications received.

    Applications expire after six months. To stay on the waitlist, you must reapply.

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  • First Adult's Information

    Head of Household
  • Birth Date*
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  • County of Residence*

  • Definition of Household: 

    A household is all individuals who reside in a dwelling unit who live and eat separately from other individuals in that unit. There may be subgroups within the same dwelling unit. One subgroup combines income and resources and eats together. Even though they pay a portion of the rent, they do not combine income or resources with the other subgroup(s) that are also paying a portion of the rent. Each subgroup is a separate household.

  • Are you applying with anyone else in your household?*
  • This program is facilitated in English, given this, would you like an interpreter?*

  • First Adult's Income

    Enter the monthly amounts for each type of income you receive.

  • Second Adult's Information

  • Birth Date*
     - -

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  • Second Adult's Income

    Enter the monthly amounts for each type of income you receive.

  • Third Adult's Information

  • Birth Date*
     - -

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  • Third Adult's Income

    Enter the monthly amounts for each type of income you receive.

  • Fourth Adult's Information

  • Birth Date*
     - -

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  • Fourth Adult's Income

    Enter the monthly amounts for each type of income you receive.

  • Household Assets

    List the estimated value of what every adult (18+) living in the household owns.
  • Do you own the house you live in?*
  • How many vehicles does your household own?*

  • Vehicle 1 - (Vehicle worth the most money)

  • Vehicle 2

  • Vehicle 3

  • Household Liabilities

    List the amounts every adult (18+) living in the household owes to others.

  • Program and Desired Asset Questions

  • 1. Do you currently participate in any Community Action programs?*
  • What Community Action programs are you currently in or receive services from? (Select all that apply)*
  • 2. Have you completed Community Action's Financial Coaching Classes?*
  • 3. Do you have a weekly/monthly budget plan that you follow?*
  • 4. Do you regularly save money each month?*
  • 5. This program requires you to make regular savings contributions of at least $50 per month/per applicant. Would your current income allow you to complete this requirement?*
  • 6. This program requires you to open a savings account with FNBO. Are you able to open a new bank account?*
  • 7. This program offers assistance with credit building and repair. Select the best description of your credit history and debt.*
  • 8. Have you experienced discrimination that has negatively impacted your ability to purchase an asset?*
  • 9. What type of asset would you like to purchase through the program?*
  • 10. Do you currently have a valid driver's license?*
  • 11. How many miles are currently on the vehicle you are wishing to replace?*
  • 12. What timeline are you considering for the purchase of a vehicle?*
  • 13. How would you use this vehicle for transportation? (Select all that apply)*
  • 10. Do you feel safe in your current living conditions?*
  • 11. How long have you had consistent income?*
  • 12. What timeline are you considering for the purchase of a home?*
  • 13. Do you qualify as a first time home owner?*
  • 10. Do you have a plan to use the degree/certificate once completed?
  • 11. Have you completed the required prerequisites? (GED, High School diploma, entry level certificates, etc.)*
  • 12. Have you been accepted or enrolled in an education/certificate program?*
  • 13. Are you the first in your family to seek higher education/work certificate?*
  • 10. Do you have a plan to use the funds for a small business start-up or expansion?*
  • 11. Do you have a business mentor or business community you can go to for support?*
  • 12. How much experience do you have in your desired business field?*
  • 13. Would your business qualify as a minority owned business?*

  • Certification of Accuracy

    By signing below, I hereby certify that all information provided on this application is accurate and complete to the best of my knowledge.
  • Date Filled Out*
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  • Should be Empty: