Please complete the brief survey application below.

Learn how to start a business and put an ESL workshop on your resume! Save Rochester's Financial Wellness Workshops are 90 minutes long, once per week, for 5 weeks. Participants will receive $50.00 to start a business checking account once they have completed 5 workshops. Workshops are for men and boys ages 12 and up.

Completing this survey DOES NOT mean you are enrolled. You must receive confirmation from Save Rochester, Inc. to confirm your enrollment. 
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100% of survey complete.

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* 1. First and Last Name

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* 2. Date of Birth

Date

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* 3. Phone Number (please include the area code ex. 585)

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* 4. Email Address

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* 5. What is your preferred method of contact? 

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* 6. Are you still enrolled in school?

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* 7. What is the name of the school that you are attending?

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* 8. Do you have children?  

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* 9. Are interested in starting your own business?

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* 10. What are your business interests?

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* 11. Have you ever taken a Financial Workshop? 

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* 12. Do you currently own an operating business? 

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* 13. Have you or anyone you know been impacted by gun violence? 

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* 14. Have you ever had a business checking or savings account?

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* 15. Have you ever been arrested, incarcerated, on parole, on probation, or received an ACD? (This is only for data purposes and WILL NOT impact our decisions)

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* 16. Current ZIP CODE

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* 18. THANK YOU FOR COMPLETING THE INTIAL STEP.

SOMEONE WILL BE IN TOUCH WITH YOU SOON. 

OVERALL, HOW DO YOU FEEL ABOUT THIS SURVEY APPLICATION? 

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