Question Title

* 1. Please provide your Name (first & last)

Question Title

* 2. Today's Date 

Date

Question Title

* 3. What is your street address? Please include the city, state and zip code here. 

Question Title

* 4. At what email address would you like to be contacted?

Question Title

* 5. Please provide the best phone numbers to remain in contact with you during this workshop

Question Title

* 6. Best way to be contacted:

Question Title

* 7. What is your gender?

Question Title

* 8. Birthdate: (MM/DD/YYYY)

Question Title

* 9. Marital Status / Household Type

Question Title

* 10. Were you born in the U.S.?

Question Title

* 11. Are you proficient in the English Language?

Question Title

* 12. Ethnicity:

Question Title

* 13. Race (check all that apply)

Question Title

* 14. Employment Status:

Question Title

* 15. Employer/Business:

Question Title

* 16. Length of time in current position (in years):

Question Title

* 17. Household Size

Question Title

* 18. Annual Household Income

Question Title

* 19. Current Status of Your Housing:

Question Title

* 20. Education

Question Title

* 21. What I currently know and understand about money and finance, I learned from (check all the apply)

Question Title

* 22. What I need to learn the most from this Financial $avvy Literacy Training Program is:

Question Title

* 23. How did you hear about the AAGACC Financial $AVVY Literacy Training Program?

Question Title

* 24. You have almost completed the Registration Paperwork! Congratulations!  Please contact the AAGACC Office and ask for your Student ID number. This will be assigned to you to confirm your participation in the Financial $avvy Literacy Training Program! THANK YOU for Registering!

T