Ways To Work Prequalification Intake

Please complete each question. Ways To Work National requires all demographic information on a client even if you do not qualify for the program currently. This will help us to determine how we can expand and offer services to all clients.

Your Name
Street Address
Apt#
City
Zip
Your Date of Birth
Your Phone Number
Best Time To Call
Your Email Address
Your Ethnicity We do not discriminate on the basis of race, religion, national origin, color, sex, age, or veteran status. This question is for demographic purposes only.
Have you served in the US Military?
Loan Request:
Amount of Request:
Are you currently working? The program requires that you are working outside the home. IF you ONLY have disability or social security income you do NOT qualify for Ways To Work. We would still like statistics about your family so we may possibly be able to help you in the future
If yes, How long have you been working with your current employer?
Ways To Work requires that the client be in the same position for the past 3 months
How much do you currently earn?
Please give your Gross (before taxes) income: Biweekly (every 2 weeks) is assumed, type ‘Monthly’ after the amount if it is monthly
Do you have children?  Yes No
How many children do you have?
Are your children under 18 years of age?  Yes No
How many people are in your household?
How do you currently get to/from work?
How is your credit?
How did you hear about the Ways To Work program?
Comments: