Financial Literacy Investment Program
Please complete the form below to register for FLIP. This program is designed to empower you with the knowledge and skills to make informed financial decisions.
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Cell Phone Number
Please enter a valid phone number.
Can we text you?
Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What are your primary goals for joining F.L.I.P.? (Please select all that apply)
Learning basic financial literacy
Understanding budgeting and saving
Building credit
Investing in stocks and bonds
Planning for retirement
Learning real estate investment
Other
How would you rate your current financial literacy?
Beginner
Intermediate
Advanced
Other
What are three goals you are looking to achieve in the next 3-6 months?
Are there any resources we can assist you in obtaining? (i.e. Food, Housing, Transportation, Personal Safety, Healthcare, Legal Aid, Employment)
Food
Clothing
Education
Finances
Housing
Personal Safety
Transportation
Other
Comments
Sign below to indicate your agreement and understanding of the following.
I understand that all information shared with Core 6 staff, mentors, volunteers and coordinators is confidential and will be used for the development, implementation and evaluation of my individual service plan, resource acquisition and reporting to granting organization that financially support Core 6 programming. I authorize the release of personal information for the purpose stated above. I understand that the Core 6 Programs and case management support is voluntary and I may withdraw from the program at any time upon notification to my Care Advocate or Core 6 Leadership. I grant permission to Core 6, its agents and employees the irrevocable and unrestricted right to reproduce the photographs and/or video images taken of me , or members of my family, for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release Core 6 and its legal representatives from all claims and liability relating to said images or video. Furthermore, I grant permission to use my statements that were given during an interview or guest lecture, with or without my name, for the purpose of advertising and publicity without restriction. I waive my right to any compensation.
Signature
Submit
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