Cabarrus Financial Empowerment Forum

Section 1: Registration and Financial Wellness Scoring

Locations and Time:
Neighborhood Networks Technology Center

265 Salem Street, SW

Concord, NC 28025

Date: March 10, 2026

Time: 6:00 - 7:30 pm

Please arrive by 5:45 pm to get signed in. Have paper and pen available for notes.

READ CAREFULLY ABOUT THE SCORING:
Scores above 50% indicates that you may want to consider a Financial Wellness Session to identify areas of concerns to be tuned up for long-term financial sustainability.

We look forward to assisting you.

Question Title

1. Participant Information - Please include First and Last name (Required.)

Name

Address

City/Town

State

ZIP/Postal Code

Email Address

Phone Number

Question Title

2. Co-participant Information - Please provide First and Last Name

Name

Address

City/Town

State

ZIP/Postal Code

Email Address

Phone Number

Question Title

3. Which location will you be attending?

Neighborhood Networks Technology Center - 265 Salem Street, SW, Concord, NC 28025

Hybrid Option - Please send Zoom Link (make sure we have correct email address as Zoom link will be emailed to you)

Question Title

4. Are you interested in home purchase? (Required.)

Yes

No, already own.

Any comments on housing need.

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5. Are you currently working with a realtor? (Required.)

Yes

Name and contact information:

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6. Are you currently working with a lender (if purchasing) or servicer (if needing help for foreclosure prevention)? (Required.)

Yes

Name and contact information:

Question Title

7. Marital Status: (Required.)

	Married	Divorced	Separated	Never Been Married	Widowed	Domestic Partner
Participant	Participant Married	Participant Divorced	Participant Separated	Participant Never Been Married	Participant Widowed	Participant Domestic Partner

Question Title

8. Marital Status:

	Married	Divorced	Separated	Never Been Married	Widowed	Domestic Partner
Co-Participant	Co-Participant Married	Co-Participant Divorced	Co-Participant Separated	Co-Participant Never Been Married	Co-Participant Widowed	Co-Participant Domestic Partner

Question Title

9. Do you need to schedule a one-on-one counseling session? Please Read This Carefully - NOTE: This is a requirement if you would like to be assess for down payment assistance funds, WeBuild's homes, need help in finding the right lending institution or need help to save a home.

The counseling will also assess your mortgage and homeownership-readiness and give you guidance on how to get to "Yes" from a lender/servicer. (Required.)

Yes

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10. Number of people in your household: (Required.)

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11. Date of Birth - Participant (Required.)

Enter your birthdate:

Date

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12. Date of Birth - Co-participant

Enter your birthdate:

Date

Question Title

13. Which race/ethnicity best describes you? (Please choose only one.) (Required.)

	American Indian or Alaskan Native	Asian/Pacific Islander	Black or African American	Hispanic	White/Caucasian	Choose Not to Respond
Participant	Participant American Indian or Alaskan Native	Participant Asian/Pacific Islander	Participant Black or African American	Participant Hispanic	Participant White/Caucasian	Participant Choose Not to Respond
Co-Participant	Co-Participant American Indian or Alaskan Native	Co-Participant Asian/Pacific Islander	Co-Participant Black or African American	Co-Participant Hispanic	Co-Participant White/Caucasian	Co-Participant Choose Not to Respond

Multiple ethnicity / Other (please specify)

Question Title

14. What is your citizenship status? (Please choose only one.) (Required.)

	US Citizens	DACA	Permanent Resident Alien
Participant	Participant US Citizens	Participant DACA	Participant Permanent Resident Alien
Co-Participant	Co-Participant US Citizens	Co-Participant DACA	Co-Participant Permanent Resident Alien

Other (please specify)

Question Title

15. Rural Area Status: (Required.)

	Household lives in a rural area	Household does not live in a rural area
Participant	Participant Household lives in a rural area	Participant Household does not live in a rural area
Co-Participant	Co-Participant Household lives in a rural area	Co-Participant Household does not live in a rural area

Question Title

16. Ethnicity Type: (Required.)

	Hispanic/Latino	Not Hispanic/Latino	Choose Not to Answer
Participant	Participant Hispanic/Latino	Participant Not Hispanic/Latino	Participant Choose Not to Answer
Co-Participant	Co-Participant Hispanic/Latino	Co-Participant Not Hispanic/Latino	Co-Participant Choose Not to Answer

Question Title

17. Limited English Proficiency Status: (Required.)

	Household is Limited English Proficiency	Household is not Limited English Proficiency
Participant	Participant Household is Limited English Proficiency	Participant Household is not Limited English Proficiency
Co-Participant	Co-Participant Household is Limited English Proficiency	Co-Participant Household is not Limited English Proficiency

Question Title

18. Preferred Language (Required.)

	English	Spanish
Participant	Participant English	Participant Spanish
Co-Participant	Co-Participant English	Co-Participant Spanish

Other (please specify)

Question Title

19. Employment Information - Participant (Required.)

Name of Employer:

Yearly Income:

Question Title

20. Employment Information - Co-Participant

Name of Employer:

Yearly Income:

Question Title

21. Do you have an emergency fund?

Yes

Question Title

22. Do you have a retirement account?

Yes

Question Title

23. I could handle a major unexpected expense.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Question Title

24. Do you feel that you are secure in your financial future?

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Question Title

25. Because of my money situation, I feel like I will never have the things I want in life.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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26. I can enjoy life because of the way I'm managing my money.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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27. I am concerned that the money I have or will save won't last

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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28. I feel like I am just getting by financially - living paycheck to paycheck

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Question Title

29. Acknowledgement: I am aware that this is an introduction to increasing financial empowerment skills and pre-purchasing & foreclosure prevention education. (Required.)

	Agree
Participant	Participant Agree	Participant
Co-Participant	Co-Participant Agree	Co-Participant

Other (please specify)

Cabarrus Financial Empowerment Forum

Section 1: Registration and Financial Wellness Scoring

Question Title

* 1. Participant Information - Please include First and Last name (Required.)

Question Title

* 2. Co-participant Information - Please provide First and Last Name

Question Title

* 3. Which location will you be attending?

Question Title

* 4. Are you interested in home purchase? (Required.)

Question Title

* 5. Are you currently working with a realtor? (Required.)

Question Title

* 6. Are you currently working with a lender (if purchasing) or servicer (if needing help for foreclosure prevention)? (Required.)

Question Title

* 7. Marital Status: (Required.)

Question Title

* 8. Marital Status:

Question Title

Question Title

* 10. Number of people in your household: (Required.)

Question Title

* 11. Date of Birth - Participant (Required.)

Question Title

* 12. Date of Birth - Co-participant

Question Title

* 13. Which race/ethnicity best describes you? (Please choose only one.) (Required.)

Question Title

* 14. What is your citizenship status? (Please choose only one.) (Required.)

Question Title

* 15. Rural Area Status: (Required.)

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* 16. Ethnicity Type: (Required.)

Question Title

* 17. Limited English Proficiency Status: (Required.)

Question Title

* 18. Preferred Language (Required.)

Question Title

* 19. Employment Information - Participant (Required.)

Question Title

* 20. Employment Information - Co-Participant

Question Title

* 21. Do you have an emergency fund?

Question Title

* 22. Do you have a retirement account?

Question Title

* 23. I could handle a major unexpected expense.

Question Title

* 24. Do you feel that you are secure in your financial future?

Question Title

* 25. Because of my money situation, I feel like I will never have the things I want in life.

Question Title

* 26. I can enjoy life because of the way I'm managing my money.

Question Title

* 27. I am concerned that the money I have or will save won't last

Question Title

* 28. I feel like I am just getting by financially - living paycheck to paycheck

Question Title

* 29. Acknowledgement: I am aware that this is an introduction to increasing financial empowerment skills and pre-purchasing & foreclosure prevention education. (Required.)

1. Participant Information - Please include First and Last name (Required.)

2. Co-participant Information - Please provide First and Last Name

3. Which location will you be attending?

4. Are you interested in home purchase? (Required.)

5. Are you currently working with a realtor? (Required.)

6. Are you currently working with a lender (if purchasing) or servicer (if needing help for foreclosure prevention)? (Required.)

7. Marital Status: (Required.)

8. Marital Status:

10. Number of people in your household: (Required.)

11. Date of Birth - Participant (Required.)

12. Date of Birth - Co-participant

13. Which race/ethnicity best describes you? (Please choose only one.) (Required.)

14. What is your citizenship status? (Please choose only one.) (Required.)

15. Rural Area Status: (Required.)

16. Ethnicity Type: (Required.)

17. Limited English Proficiency Status: (Required.)

18. Preferred Language (Required.)

19. Employment Information - Participant (Required.)

20. Employment Information - Co-Participant

21. Do you have an emergency fund?

22. Do you have a retirement account?

23. I could handle a major unexpected expense.

24. Do you feel that you are secure in your financial future?

25. Because of my money situation, I feel like I will never have the things I want in life.

26. I can enjoy life because of the way I'm managing my money.

27. I am concerned that the money I have or will save won't last

28. I feel like I am just getting by financially - living paycheck to paycheck

29. Acknowledgement: I am aware that this is an introduction to increasing financial empowerment skills and pre-purchasing & foreclosure prevention education. (Required.)