Success Series Fall Semester 2023 Application
We are so excited to have you join our journey to Success. We offer our Success Series course every semester to only a few selected individuals ready to invest and work for their future and the future of their family and community. 

Our Success Series Program addresses the whole person with our Wholistic approach to empower individuals to live a provisional lifestyle (ability to provide for oneself). We do this through a loving and safe environment, with accountability and support from our mentors and budget counselors from the community and opportunities to connect with community partners and resources, receive a free meal and earn incentives such as gift cards, oil changes, and more. 

We provide a Youth program (ages 8 - 15) and childcare (0 - 8) for families attending the program. The youth program will work on skills associated with age-appropriate activities related to our adult program. 

The only fee for the program is $25 for the workbook binder (scholarships available for fees or through serving during the program) and $10 for the binder for youth (there are opportunities for the youth to earn the cost for the program). 

This semester we can only receive 10 participants. We determine this through the order of submissions, commitment, and dedication, and July 31st is the last day to apply. 

If selected, you will hear from us between August 1 - 7

This course runs weekly on Thursdays from August 24the to December 21st from 5:30 - 8:00 pm.

Answer each question honestly. The answers to the questions will not disqualify you and allow us to better understand who you are. Not answering questions will harm your chances of being selected. 

All Information is kept confidential.

**Don't let cost be a reason for you not applying; we have opportunities for you to get this paid 
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Name *
Birthdate  *
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Zip code  *
Phone number  *
Email Address  *
Affiliated with any church or organization? Please name below
Were you referred by anyone? If so list below. 
Educational Level  *
Marital Status  *
Employment Status  *
Income Bracket  *
Household Size  *
Name and ages of children for childcare or Youth Program
What are you hoping to get from the program this semester? *
What subject or support do you need the most? Select all that applies  *
Required
How can you contribute to the program (list talents, gifts or passions)?  *
Are you committed to investing in yourself and family for the next 4 months?  *
How did you hear about us?  *
If you have any additional questions or comments, contact us at info@escapefrompoverty.org or call 337-984-4858
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