Money Mentors - Participant Enrollment Form 2020-2021

Money Mentors - Participant Enrollment Form 2020-2021

Please complete this application to receive help from the Money Mentors program. All information will be kept confidential. We will use this information to pair you with a Money Mentor.
 
Questions are asked about your job status, how often you are paid, the number in your family, your financial concerns, etc. so that we can find you a mentor who will be a good match for you.
 
Some questions like "What's your age?" are asked in order for us to continue receiving funding for this program.
Contact Information
Please enter your contact information. Contact fields marked with an * are required. Your contact information will not be sold or given to any organization. It is for internal University of Illinois Extension use only. If you do not enter a valid e-mail address, you will not receive a confirmation of your registration.

Contact Information
Please enter your contact information. Contact fields marked with an * are required. Your contact information will not be sold or given to any organization. It is for internal University of Illinois Extension use only. If you do not enter a valid e-mail address, you will not receive a confirmation of your registration.
 

 

 

 

answer must be a zipcode like 61864 or 61864-8180

 

answer must be an email address

 

answer must be phone number with area code like 217-333-1000