Mentee Application Form for FLMP

Habitat Financial Literacy Mentor Program Mentee Opt-In
Please complete this form and submit all required documentation. Once we have received and reviewed your completed form and supporting documents, we will contact you regarding your eligibility and next steps to begin the program.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What county do you live in?
How many people are in your household?
Please select what are your financial goals. Select all that apply:

Other
Please load a screenshot of your current credit scores. Please note, this will not impact your eligibility.

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Please load here three (3) months of paystubs here

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Please load two (2) years of tax returns here

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Please load other income such as (child support, SSI, Social Security, etc.) here

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Met eligibility?
Courses Completed?
Habitat of Horry County
Should be Empty: