ONAC Credit Counseling, Homebuyer Education, and/or Money Management Coaching Registration Form

ONAC is providing three types of free financial coaching to American Indians and Alaska Natives and others in the United States: 1) credit builder/credit counseling sessions, 2) homebuyer education, and 3) money management coaching (i.e. help with budgeting).

Confidential sessions are offered one-on-one, by teleconference (Zoom) or phone call, with certified credit counselor, homebuyer education provider, and/or financial educators. Typically, these sessions will last for a minimum of thirty minutes and, depending upon the financial coach, are available on weekdays and Saturday mornings.

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* 1. To begin registration for financial coaching, please let us know your financial goals below (you may check more than one):

Money management/budgeting

Buying a home

Setting a goal to raise your credit score

Being debt-free in 24 months

Starting a business

Purchasing a car

Planning to start, or finish, post-secondary education

Please share any other financial goals you have here:

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* 2. To register for coaching sessions, please provide your contact information below:

Name (First, Middle, and Last)

Street/Mailing Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. What is your age?

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* 4. What is your gender?

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* 5. What is your tribal affiliation? If N/A, type N/A to proceed.

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* 6. What is your race and/or ethnicity or tribal political identity? Select all that apply.

American Indian or Alaska Native (this is a political identity and not a racial or ethnic identity)

Asian or Asian American

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or other Pacific Islander

White

Mixed Race

Prefer to Not Answer

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* 7. Are you a farmer, rancher, or fisher? (Your answer will not impact your ability to receive financial coaching services).

Farmer

Rancher

Fisher

None of the above

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* 8. Do you currently have a checking or savings account in your name?

Yes, I currently have a checking and/or savings account in my name.

No, I do not currently have a checking or savings account in my name and do not wish to open one.

No, I do not currently have a checking or savings account in my name, but I am interested in receiving information about safe and affordable bank accounts.

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* 9. Which financial coaching services would you like to request from ONAC at this time? All services are one-on-one, free, and confidential. (You may select more than one.)

Financial education (such as one-on-one help with budgeting) available via phone and teleconference

One-on-one credit counseling available via phone and teleconference (and, as needed, possible access to a credit builder loan, through the Citizen Potawatomi Community Development Corporation)

Homebuyer education available via phone and teleconference (if you are hoping to buy a home later)