Learn and Save Waitlist

Learn and Save Waitlist

PLEASE COMPLETE
Welcome to the waitlist application for the Harrison and Diane Quirk Learn & Save Program! If you're a low-to-moderate income resident of the Quaboag Region and Southern Worcester County, you could be eligible for this FREE, 12-month matched savings program.

The program runs from January to December each year, and participants who successfully complete the program will receive matched savings at the end. Please fill out the form below to be added to the waitlist.
Step1

PLEASE LET US KNOW IN WHICH TOWN YOU RESIDE
BelchertownBrimfieldBrookfieldCharltonDudleyEast BrookfieldHamptonHardwickHollandLudlowMonsonNew BraintreeNorth BrookfieldOxfordPalmerSpencerSouthbridgeSturbridgeWalesWareWarrenWest Brookfield
If you do not reside in any of these towns, YOU ARE NOT ELIGIBLE for the program. Please reach out to our office for potential future programs. Call Lindsey at 413-497-4409
Step 2

PERSONAL INFORMATION
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Step 3

INCOME ELIGIBILITY
Combined Income*
Family Size*
Please select from dropdown
Step 4

BUSINESS OWNERSHIP
YESNO
If yes, please provide business name:*
Step 5

COMMITMENT TO SAVINGS
YESNO
If YES, please indicate how much you anticipate being able to save each month:*
YES
(Note: Successful completion of the program includes making all monthly deposits ontime and attending and participating in all Zoom lessons.)
Step 6

APPROVED ASSETS FOR MATCHED SAVINGS
The savings you accumulate through this program must be applied to an approved asset such as: Education, Housing, Applicances, Small Business, Vehicle, Necessary Home Repair.
EducationHousingAppliancesSmall BusinessVehicleNecessary Home Repair
Step 7

PROGRAM COMPLETION EXPECTIONS
I understand that the Learn & Save Program runs from January toDecember each year. To successfully complete the program and receive matched savings, I must:
- Make all monthly deposits in full and on time
- Attend and actively participate in all monthly Zoom lessons
YES
Step 8

TIMELINE AND FOLLOW-UP
Please Note:
- We will review all waitlist applicants in the fall of 2025.
- Eligible applicants will be contacted at that time and invited to complete an official application form and provide income verification.
Step 9

CONSENT AND SUBMISSION
YES
Step 10

SUBMIT WAITLIST APPLICATION
Please verify that you are human*
Should be Empty:

Learn and Save Waitlist

Step1

Step 2

Step 3

Step 4

Step 5

Step 6

Step 7

Step 8

Step 9

Step 10