Financial Coaching Service Form
This is a free service where you can meet one-on-one with a financial coach either online or in person. We will work together to meet your financial goals, such as budgeting, saving, and improving your credit. To enroll please read and understand the coaching disclosure and fill out the MAM intake form.
 MAM will not share your information without your written permission. 
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1. Financial Coaching is a free service provided by Memorial Assistance Ministries and there is no cost for this service.  Neither the Financial Coach or the Client will ask for nor exchange money for services.

2. That the Clients will make final decisions on creating and following action steps.  Both parties will work together if the action steps need to be revised for a better solution.

3. If questions or issues arise that cannot be answered or resolved to contact the Director of Family Education Programs for further assistance.

4. Financial Coach and client only meet at Memorial Assistance Ministries' locations and partner agencies.


Financial Coach agrees to:

1. Maintain Client confidentiality including conversations and records.

2. Will not judge the Client, but will encourage the Client to be responsible for his or her life decisions.

3. Agrees to act as an accountability support for the Client, while providing information, resources, references and support only


Client agrees to:

1. Be honest in discussions with Financial Coach so he/she can receive the

most appropriate services and referrals.

2. Respect Financial Coaches time and notify if going to be late for appointments, cancellations or rescheduled appointments. (within a 24 hour period)

3. Understands that the Financial Coach cannot act as legal counsel, tax advisor or financial advisor or any other advisor. Financial Coaching is not a substitute for financial advice from a licensed financial institution, accountant, or tax or legal advisor. If Client desires assistance in understanding more about finances or related services, they should see a qualified financial advisor.

4. Agrees to exercise his or her own research and analysis before making decisions and is responsible for his or her own actions and choices as it relates to his or her personal financial decisions.

5. Understands that Memorial Assistance Ministries does not recommend a specific financial institution, product, services or organization over another.  


By signing this form, I agree to participate in a Financial Coaching process and I understand that:

Memorial Assistance Ministries is not a credit counseling agency, a financial services agency, a housing counseling agency or a tax or law advising agency and does not guarantee any specific outcomes. The information provided during the financial education workshops, classes and all coaching sessions, group or one-on-one and any related details are for information purposes only. MAM cannot guarantee that you will qualify for a loan or any loan related services, such as a home, car, or loan modifications or refinance options. All decisions made by the clients are their personal obligations and decisions.

• The services that Memorial Assistance Ministries provide are funded by private funding, in order to continue providing services; MAM must know your personal finance information. For that reason I authorize MAM to know my personal information, such as bank statements, credit score, budget, income, expenses, loans, debts, tax return between others. Also, I authorize MAM to pull my credit from credit reporting sources for the purpose, and I further authorize and permit Memorial Assistance Ministries to obtain updated information from credit reporting sources every six months.


Do you agree with the above statement? and would you like to participate in coaching service?

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What would you like to work with a Financial Coach? What assistance do you need? *
First name and Last name *
Gender *
What is your preferred pronoun?  *
Date of Birth *
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DD
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YYYY
Ethnicity *
Race *
Native Country *
Preferred Language *
Veteran *
Housing: *
Disability or special healthcare need? *
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