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Financial Empowerment
Food Safety Training
Cart
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Shop
Find Restaurants
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AIR Restaurants
Restaurant Member Benefits
AIR Sponsors & Partners
Partner Member Benefits
News
Events
About
About AIR
Join AIR
Financial Empowerment Program
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Financial Empowerment Pilot Program Participant Application Session 5
Your Name
(Required)
First
Last
Preferred Name
Name
Your Address
(Required)
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
County of Residence
For example: Buncombe, Haywood, Madison, Henderson
Date of Birth
(Required)
Email Address
(Required)
Email Address
Confirm Email Address
Mobile Phone
(Required)
I agree to accept texts or calls from FEPP coaches and AIR in regard to this program.
(Required)
Yes
Restaurant of Employment
(Required)
Current Position
(Required)
How long have you been employed at your current restaurant?
(Required)
Applicants must have permission from their supervisor or restaurant owner to participate in the program. Wage and hours info will be verified by supervisor. Restaurant is expected to pay employee to participate in the one-day workshop.
Name of your supervisor at the restaurant.
(Required)
Email address for your supervisor.
(Required)
Mobile Number for Your Supervisor
(Required)
The following questions are to assess eligibility for the program. In line with the requirements of the Dogwood Health Trust grant, preference will be given to candidates at or below 51% of the Buncombe County AMI for family size.
Do you work full-time or part-time?
(Required)
Full-time
Part-time
Average Hours Per Week
(Required)
Average Hourly Wage (including tips)
(Required)
Gross (before taxes) Monthly Salary (including wages + tips)
(Required)
Take Home/Net (after taxes) Monthly Salary (including wages + tips)
(Required)
Total Number of People in Household
(Required)
Total Monthly Family Income (Take Home/Net)
(Required)
Do you own your home?
(Required)
Yes
No
What is your monthly housing cost?
(Required)
Do you have a savings account?
(Required)
Yes
No
What other benefits do you receive?
(Required)
Health Insurance
Paid Time Off
Direct Primary Care
Retirement Plan/401K
Other
If you selected other above, please identify other benefits you receive.
Would you need an interpreter to participate in this course? What language?
Demographic Information
Gender
Race
(Required)
American Indian or Alaskan Native
Asian
Black or African-American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Other
Personal Statement: Please describe why you are interested in this program and what you hope to gain from it. Personal statements will be given strong consideration when reviewing applications.
(Required)
Availability and Commitment
Program sessions are important for participant success, please agree to the following.
Attending mandatory two-day workshop.
(Required)
I understand
Attending monthly group sessions, 1 per month for 6 months, 2 hours each
(Required)
I understand
Attending 30-minute monthly individual coaching sessions, 1 per month for six months.
(Required)
I understand
Creating a monthly savings plan and making 6 different monthly savings deposits each month.
(Required)
I understand
Paying $25 for the initial workshop.
(Required)
I understand
Scheduling all of your participation time in advance with your employer.
(Required)
I understand
Is there anything else you would like us to know about you or any specific topics you hope the program will cover?
Thank you for applying to the FEPP Program. We appreciate your commitment to enhancing your financial stability/growth, and we look forward to working together on your goals. By submitting this application, you confirm that the information provided is accurate, and you agree to actively participate in the FEPP. Successful applicants will be notified via contact information provided.
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