AcceLOUrate Coaching Sign-up Form
By filling out this form you are agreeing to have the information within this document shared between staff members within the Office of Financial Empowerment and the coaches within the AcceLOUrate Savings program for scheduling purposes. Your information will not be shared for any other reason. 
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What is your full name?
What is your email address?
What is your phone number?
Do you prefer to be contacted by email or by phone to set up your first session?
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Do you have a preference on having in-person or virtual meetings with your coach?
Clear selection
Are you signing up to meet with a specific coach? If not, please select the last option and we will assign a coach to you.
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We are happy to provide reasonable accommodations as needed for clients. Please indicate if any accommodations are needed: 
If you submit this form and do not hear back from a coach to schedule within 10 business days, please email Ce Garrison at cynthia.garrison@louisvilleky.gov. We ask that you write this email down and save it. We do not anticipate any error in our coaches scheduling with you, however, technical difficulties do arise. Ce will help with those issues and connect you with a coach. Please type your name to verify that you understand this statement and have saved Ce's email address in case of any issue. 
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