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VEHICLES EMPOWERING HOPE
First name
*
Last name
*
Birthday
*
Month
Day
Year
Multi-line address
Country/Region
*
Address
*
City
*
Zip / Postal code
*
Email
*
Phone
*
If you are currently enrolled in school enter name of school, program of study AND grade level:
*
What is your future employment or education goal
*
Are you currently employed or soon to be?
*
How will you pay for gas, car insurance and the maintenance on a vehicle?
*
Have you ever received a ticket or been at fault in a car accident? If yes, please explain. If no, N/A
*
Explain how having your own vehicle would impact your life. (At least 500 words) Please do not use AI/chatGPT to write your essay. *
Upload your Drivers license
*
Upload File
Upload proof of employment
*
Upload File
Signature (By signing this application, if you are selected to receive the vehicle, you are promising to complete the Basic Budget Workshop, and the Car Maintenance Overview).
*
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Date picker
*
Submit
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