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 individual be working for the same employer for at least 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? YesNo
    How many children do you have?
    Are your children under 18 years of age? YesNo
    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: