Budgeting Basics - Brunswick- 2.27.20 NVME Registration

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Budgeting Basics will be held on Thursday, February 27, 2020 from 1:00 - 3:00 pm at the University of Maine at Augusta Brunswick Center, Orion Hall, 12 Sewall St. Room 101, Brunswick.

If you require accommodations to participate in this class, please contact Lisa Archer at 207-386-1664 or email lisa.archer@maine.edu.

Thank you for providing the following information. Your name and contact information will not be shared. Aggregate data is used for the purposes of reporting to our funders and measuring the success of our programs.

All fields are required on the registration form. Please contact Lisa Archer at 207-386-1664. if you prefer a paper copy or have any questions. If you have taken a class with NVME recently, contact Lisa Archer. Your registration information may already be on file.

You may be contacted in the future to provide feedback on your experience with NVME.

Name - First *

Name - Middle

Name - Last *

Date of Birth *

YYYY

Address *

City *

State *

Zip *

Email *

Phone number *

Alternate phone number

How did you hear about us? *

Sign me up for the email news about our programs? *

Yes

Required

Gender

Female

Male

Undisclosed

Other:

If you are of Franco-American heritage, please check here.

Franco-American

Other:

If you consider yourself Hispanic or Latino, please check here.

Hispanic or Latino

Other:

In addition, check one or more of the following racial categories to describe yourself. *

White

Asian

Native Hawaiian or Pacific Islander

Black or African American

Native American or Alaska Native

Other - check here and continue to the next question.

Required

If you chose other above, please list here.

Work Status *

Employed

Employed part-time or seasonal

Unemployed

Self-Employed

Retired/semi-retired

Required

I have a disability that limits my work *

Yes

Required

I receive SSI, SSDI, or veterans disability? *

Yes

Required

I am a veteran, active duty military or reservist *

Yes

Required

I receive unemployment insurance (UI)? *

Yes

Required

I am looking for work *

Yes

Required

Education Information *

Did not complete high school

High school dimploma/HiSET/GED

College coursework

Trade School certificate

Associates Degree

Bachelors Degree

Post-bacculete coursework

Graduate degree

Other

Required

Are you currently enrolled in school? *

Yes

Required

If you are currently a student, what kind of program are you enrolled in?

HS/HiSET/GED

College prep

Trade School

Associates Degree

Bachelor Degree

Graduate Degree

Major field of study?

Are you a University of Maine Augusta student? *

Yes

Number of people in your household including you *

Total monthly Income for your household (from all sources) *

Health Insurance coverage (choose one) *

Self - if household of one with insurance, select this option

Some members

All household members

No one

Are you the Head of Household? *

Yes

Are you a single parent? *

Yes

My household receives food stamps. *

Yes

My household receives TANF. *

Yes

I have savings. *

Yes

I have retirement savings. *

Yes

Submit

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