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What We Do
Get Involved
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HANDS Savings Program Application

Empower Your Financial Future

IMPORTANT! Use the tracker bar to move through all 5 steps and ensure each step is fully submitted. Only fully completed applications will be reviewed. Click “Next” at the bottom of each page to continue. You may also click “Save and Continue Later” if you need to return to your application at another time.

Step 1 of 5

20%

Company

This field is for validation purposes and should be left unchanged.

Referral Information

Referring SVdP Conference

If applicable

Caseworker Name

First Last

Email

Phone

Your Information

Name(Required)

First Last

Which county do you live in?(Required)

Email(Required)

Best contact number(Required)

Permission to text number if necessary?

Yes

How many children live in the home?(Required)

Do you have transportation?(Required)

Yes

No

Were you a participant in a Motel 2 Home Program?(Required)

Yes

No

Have you utilized SVdP assistance in the last six months?(Required)

Yes

No

How long have you been in your current job?(Required)

Less than 6 months

6-12 months

12-24 months

24+ months

Other

Is your employment secure?(Required)

Yes

No

How long have you lived at your current address?(Required)

Less than 6 months

6-12 months

12-24 months

24+ months

Other

Do you currently have a checking and/or savings account?(Required)

Yes

No

Do you have access to a computer/laptop and an internet connection at this time?(Required)

Yes

No

What is your current, total, gross (before taxes and deductions) monthly income?(Required)

Please include employment SSI, child support, SSDI

Do you have a current, realistic working budget?(Required)

Yes

No

Are you willing to attend a monthly virtual financial class via zoom with camera on?(Required)

Yes

No

What is the best time and day of the week for you to participate in the one hour, virtual financial class?(Required)

How motivated are you on a scale of 1-10 to participate in the HANDS Savings Program?(Required)

Please share your personal reason or goal for wanting to participate in this program.(Required)

Are you willing to save an amount of money each month that is NOT touchable under any circumstances?(Required)

Yes

No

Are you wiling to share your personal savings account balance and credit report information with HANDS team?(Required)

Yes

No

Are there any LIFE SKILLS topics that you would like to discuss?(Required)

Please select all that apply.

Car repairs

Apartment maintenance

Taxes

Parenting/child costs

Healthcare/medication

Credit cards

Landlord/tenant rights

Payday loans

Affording nutritious foods

Transportation barriers

Creative solutions to increase household income

Other

None

Please share the topic you would like to discuss.

Please share a song or phrase that reflects your feelings and/or relationship about the topic of money.(Required)

Is there anything else you would like to share about your HANDS application?

Contract

The HANDS Saving Program is an opportunity for families with children to work on maintaining their permanent housing situation by mastering basic budgeting, learning life and financial literacy skills and developing a savings mind-set that will aid them in becoming self-sufficient and financially stable. Financial incentives, education, mentoring, and relationship building are an important part of the program. This program is a six-month commitment to improving a family’s financial wellness and aiding them in securing their future. You will need internet access and a laptop/Chromebook. If you do not have one of these, we can give you a Chromebook. The HANDS Program: Savings Match, Financial Incentives & Bonuses SVdP GA will match savings up to $150 per month for 6 months ($900 total). You must place a minimum of $20 in your savings account each month. Credit score improvement from beginning to end of the program resulting in a 20-point increase in your score will earn a $100 BONUS. If you continue your saving habit after this 6 month program ends, and you place a minimum of $20 in your savings account each month for months 6-12, you will earn a $200 BONUS. Participants cannot put $900 in savings account at month six. You must be saving consistently monthly. Your savings match and credit score bonus (if applicable) will be paid by deposit to the savings bank account at the end of month 6. The bonus for continued saving will be paid in month 13, if applicable.

Name

First Last

Rules for Participation

Please check each box to agree that you have read and understand each of the program rules:

Please check each box to agree that you have read and understand each of the program rules:(Required)

1. I will have an open checking and savings account before the first HANDS zoom meeting.

2. I agree to share screenshots of my monthly savings account ledger with St. Vincent de Paul Georgia.

3. I agree to share my credit report scores with St. Vincent de Paul Georgia at the beginning and end of program.

4. I have access to a computer that can do Zoom with a camera or I have requested a Chromebook from St. Vincent de Paul Georgia.

5. I agree to participate in a virtual financial class for 1 hour each month.

6. I understand I will be joining others on zoom calls and I agree to be on camera. I understand that being on camera is important to this program.

7. I understand I will be removed from the program if I miss 2 consecutive zooms or I am not captured on the registration for zoom recordings.

8. I understand that while I agree to be on camera for zoom calls, any financial or other personal information I disclose about myself is voluntary. I understand that St. Vincent de Paul Georgia is not asking me to share my personal information with other members of HANDS and any disclosure I choose to share is voluntary.

9. I commit to completing a monthly homework assignment.

10. I have signed all HANDS Saving Program documents and will complete A Financial Well-Being survey at the beginning and end of the program.

11. I understand I will be removed from the program if I fail to meet the savings requirements.

12. I am open, ready, willing and motivated to change my relationship with money.

13. I understand that matching funds will be dispersed to me when all forms and online assessments are completed and verified by facilitator.

14. I understand that receiving matching funds may impact my receipt of public assistance, for example, SNAP, TANF, or social security assistance. I understand this and I assume this risk entering this program. *More info is available at the links below this form.

Agreement to Participate:(Required)

I understand that the HANDS Saving Program is a voluntary program and I am choosing to participate. I attest that I am committed to working on my financial wellness and ensuring that I can maintain my permanent housing and become more self-sufficient and financially independent.

I agree.

Signature

Date(Required)

MM slash DD slash YYYY

Release of Information Form

Name

First Last

Release of Information(Required)

I agree to authorize the sharing of the following information with the HANDS Savings Program from the date of enrollment for a 12-month period.

I agree to release and share the following information with HANDS Saving Program facilitator and administrators.

- My saving account information and balance ledger via screenshot.

- My credit report and score in January and June.

- My Wellness Online Assessments will be completed in January and June.

I grant St. Vincent de Paul the absolute right and permission to use in perpetuity my name, personal narrative, personal biography, my likeness and photograph(s), in whole or in part, or distorted in character or form, either alone or accompanied by other material, throughout the world, for the purpose of advertising, publicity, education, fund-raising, trade, or any other lawful purpose whatsoever, in any media now known or ever developed. Your name can be changed, if requested. All over eighteen in the household must sign their own form.

I agree.

Signature

Date(Required)

MM slash DD slash YYYY

Budget

Total Income

Monthly take-home pay

Other Income

Total Income

Fixed Expenses

Expenses that don’t change each month.

Housing (rent/mortgage, insurance and taxes)

Car Loan

Renter's Insurance

Car Insurance

Savings

Debt Payments

Other

Total Fixed Expenses

Variable Expenses

Expenses that can change every month.

Food at home

Food away from home

Electricity/Heating Oil/Natural Gas

Cell phone

Clothing

Gasoline

Entertainment

Other

Other

Total Variable Expenses

Periodic Expenses

Expenses that only happen once and a while.

Car maintenance and repairs

Other

Other

Total Periodic Expenses

Total Income

Minus Total Expenses

Over/Under

CFPB Financial Well-Being Scale

Following a rigorous research effort to develop a consumer-driven definition of financial well-being, the Consumer Financial Protection Bureau (CFPB) developed and tested a set of questions–a “scale”–to measure financial well-being. The scale is designed to allow practitioners and researchers to accurately and consistently quantify, and therefore observe, something that is not directly observable–the extent to which someone’s financial situation and the financial capability that they have developed provide them with security and freedom of choice. We thank you in advance for taking the time to answer this financial well-being questionnaire honestly. The results will allow us to shape the HANDS Savings Program to meet your level of financial security and freedom. If you have any questions about the form or have any trouble completing it, please contact Colleen, the Case Manager, at chiggins@svdpgeorgia.org.

In this section, please select how well the statement describes you or your situation.

I could handle a major unexpected expense.(Required)

I am securing my financial future.(Required)

I can enjoy life because of the way I'm managing my money.(Required)

I can enjoy life because of the way I'm managing my money.(Required)

I am just getting by financially.(Required)

I am concerned that the money I have or save won't last.(Required)

In this section, select how often the statement applies to you.

Giving a gift for a wedding, birthday or other occasion would put a strain on my finances for the month.(Required)

I have money left over at the end of the month.(Required)

I am behind with my finances.(Required)

My finances control my life.(Required)

Tell us about yourself.

How old are you?(Required)

18-61

62+

How did you take the questionnaire?(Required)

I read the questions.

Someone read the questions to me.

Mission

To serve our neighbors with love and respect: delivering help, hope, and pathways to self-sufficiency.

Location & Hours

2050-C Chamblee Tucker Road
Atlanta, GA 30341

Monday - Friday:
8:30 AM – 4:00 PM

Contact

Main: (678) 892-6160

Assistance: (678) 892-6163

Pharmacy: (770) 687-2610

info@svdpgeorgia.org

Donations: gifts@svdpgeorgia.org

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