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Family Self Sufficiency's Next Level Savings Program Progress Report

  1. Employment
  2. Do you get any benefits from your employer? (check all that apply)
  3. Do you have a disability that affects your ability to work?*
  4. Education
  5. What is the highest level of school you have completed?*
  6. Are you currently enrolled somewhere to further your education?*

    (i.e. certificate programs, associate's degree program, bachelor's degree, apprenticeships, etc.)

  7. Resources Your Household Receives
  8. Are you or any members of your household receiving: (check all that apply)*
  9. For Households with Children
  10. Needs/Wants
  11. Are you interested in receiving more information on any of the following services? Please check all that apply.*
  12. Leave This Blank:

  13. This field is not part of the form submission.