FINANCIAL PLANNING WORKSHEET 1Personal Information2Expenses3Income4Review & Sign Name* First Last Date of Birth* MM slash DD slash YYYY Email This field is hidden when viewing the formUser IDThis field is hidden when viewing the formName* First Last This field is hidden when viewing the formEmail Employment InformationAre you currently employed?* Yes No Are you employed…* Full-time Part-time How many hours per week do you work?*Schooling InformationAre you currently attending school?* Yes No What is your major?*Have you applied for financial aid?* Yes No When you applied for Financial Aid, what was the response?*GoalsWhat specific assistance are you seeking from Workforce Solutions Panhandle?*How are you planning to meet the majority of your living and/or training expenses?*What is your backup plan if no assistance is available?* Monthly Living ExpensesPlease list the total monthly amounts for all bills listed below. If an item does not apply to you or you have no bills in that category, enter 0.How many family members live in your home?*(A family is defined by those related by blood, marriage, or court order, i.e., husband, wife, children)Rent or Mortgage payment*Utilities (gas/water/electric)*Childcare*Child Support You Pay*Family Food Cost*Transportation: Gas*Transportation: Car Payment(s)*Transportation: Auto Insurance*Total Transportation Expenses*(Automatically calculated from amounts entered above.)TOTAL MONTHLY LIVING EXPENSES*(Automatically calculated from amounts entered above.)Monthly Expenses InformationAre you receiving HUD/FIT Assistance?* Yes No Are you receiving utility assistance?* Yes No Are you on Workforce Child Care Assistance?* Yes No Does anyone assist you with your transportation (gas, car payment, insurance) expenses?* Yes No Do you receive SNAP (Formerly Food Stamps)?* Yes No Are you behind on Child Support payments?* Yes No Monthly ResourcesPlease list the total monthly amounts for all income categories listed below. If an item does not apply to you or you have no income in that category, enter 0.Your Wages*Spouse's Wages*Unemployment Benefits*Social Security Benefits*G.I. Bill/Veteran's Benefits*Work Study Income*Child Support Paid to You*HUD/FIT Rental Assistance*TANF ((Temporary Aid To Needy Families (Cash Assistance))*SNAP (Formerly Food Stamps)*Workforce Child Care Assistance*Monthly Family Contributions*Other Income*Please Describe Other Income*TOTAL MONTHLY RESOURCES*(Automatically calculated from amounts entered above.)Resources Awarded for Upcoming SemesterPell Grant/scholarships*Unsubsidized & Subsidized Student Loans*TOTAL FOR SEMESTER*(Automatically calculated from amounts entered above.)Monthly Resources Additional InformationWill you continue to work during school?* Yes No When did Unemployment Benefits Begin?* MM slash DD slash YYYY Is Child Support Consistent/Reliable?* Yes No Do you have a Workforce Child Care Assistance co-pay?* Yes No How much is your Workforce Child Care Assistance co-pay?* Review & SignReview the information you have entered, then sign and submit the form. If you need to make a change to something, use the “Previous” button below to go back. {all_fields}Type Your Full Name To E-Sign This Form*LinkedInThis field is for validation purposes and should be left unchanged.