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Individual Development Accounts

Inquiry Form

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Personal Information

Mr. Mrs. Ms. Miss
First Name* Last Name*
Home Address City
State
Zip
Home Phone* E-mail Address
What are you interested in saving for?* Home Ownership Higher Education Small Business
Employment Information
Primary Employment Status* Employed more than full-time (overtime or more than one job, for yourself, or others)
Employed full-time (35-40 hours for yourself or others)
Employed part-time (up to 35 hrs. for yourself or others)
Working and in school or job training
Laid off, waiting for call back
Currently in school or job training
Currently seeking employment
Homemaker, not seeking employment
Disabled, not seeking employment
Retired, not seeking employment
Unknown
Referral Source

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Affidavit
By clicking the Submit button below, you indicate that you have read and meet the Income Guidelines for the IDA program.
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