Loan Application -1- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com The Community Empowerment Fund University of North Carolina at Chapel Hill Campus Y The Community Empowerment Fund provides no-interest loans of up to $300 for persons in need of employment or self-employment assistance in the greater Triangle area CEF loans are meant to directly assist borrowers in acquiring or expanding employment opportunities This includes, but is not limited to, loans for the purchase of goods, trainings, start-up funds, equipment, tools, uniforms, and transportation costs Loans are given on the basis of the application process, which includes the following written application and a personal interview Priority is given to applications which include referrals from social service agencies within the greater Triangle area Upon approval, a flexible repayment schedule will be worked out according to the client’s financial situation Upon entering into a loan with CEF, all borrowers also agree to enter a program CEF’s program is meant to better enable all borrowers to repay their loan by equipping members with the tools and opportunities needed to succeed Programmatic requirements include: Group meetings: Borrowers will be paired with other members of the program and required to attend weekly group meetings Repayments will be made during this scheduled meeting time, and all borrowers in the group will be able to use this time to address any issues with their loan officer and to network with each other Workshops: To financially empower borrowers beyond the terms of their loan, borrowers will be required to attend financial literacy trainings Depending on a borrower’s skill set and stated needs, additional workshops may be required (i.e vocational trainings, computer literacy) Savings program: CEF emphasizes the importance of personal and group savings throughout the loan term Borrowers will be required to save a percentage of their income throughout the loan term, and will make deposits to their personal savings accounts along with scheduled loan repayments To ensure that the savings account can become a tool to transitioning out of homelessness, borrowers will have limited access to their personal savings accounts until their loan is fully repaid In addition, in order to participate in the program, CEF requires the borrower to deposit a fixed amount of their own funds into savings before the loan is dispersed This amount will be matched by CEF Rehabilitation: In the case that a borrower has a history of substance abuse, mental illness, or alcoholism, CEF will consult with the relevant service provider(s) NOTE: For all of these requirements, CEF loan officers will work with borrowers on an individual basis to determine appropriate and manageable levels of each requirement 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -2- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Guidelines to Applicants Information provided to CEF throughout the application process is used solely for the purpose of making the loan and evaluating the programs of CEF CEF reserves the right to call the applicant’s landlord, employer, support service provider, and references for verification of all information Additionally, CEF reserves the right to review an applicant’s credit history In the case of a failure to repay, CEF reserves the right to deny future loan applications Please use the following guidelines to ensure that your application is complete and can be processed promptly It is to the client’s advantage to fill out this application as completely and accurately as possible Any dishonesty will result in immediate termination of the application CEF encourages clients to be as detailed as possible with their responses and to enclose additional information such as pay stubs or other income verification, and documentation of assistance from other helping agencies, so that we can best accommodate each individual’s circumstances CEF prefers those applicants who have demonstrated a strong commitment to transitioning into a better situation, whether more stable employment or moving out of homelessness into a more permanent circumstance Because loans are limited to a maximum of $300, CEF favors working in concert with other support agencies to ensure client stability CEF will assess each applicant’s stated needs and seek out available resources in the community that may be provided in addition to or in the place of a monetary loan Please contact a CEF representative if you have any questions regarding filling out the application 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -3- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Section 1: General Information Application Date _ Loan Officer Name _ Client Information: First Name _ Last Name _ Date of Birth _ Country of Birth _ SS# Mailing/Residence Address _ City _ State _ ZIP _ Residence Phone Number _ Cell Phone Number Best times to call Email Address Employment: Full-Time Part-Time Unemployed Business Name Supervisor Name Address City _ State _ ZIP _ How long have you been employed there? _ Telephone _ 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -4- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Personal Information: (Responses to these questions will not affect your opportunity to work with CEF staff) Language Preference: English Spanish Other _ Job Skills/Interest(s) _ Level of Education Method of Transportation Family Composition: Number of adults Number of children and ages Convictions: Yes _ No _ Pending Charges Yes _ No _ Description Currently on Probation Yes _ No _ Probation Officer & Contact Information _ Do you have a history of or have you ever been treated for: Mental Health Issues? _ Currently? Yes No Past/Current Provider _# _ Substance Abuse? Currently? Yes No No If yes, when? Past/Current Provider _ # _ Alcoholism? Currently? Yes If yes, when? If yes, when? Past/Current Provider _ # _ 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Loan Application -5- Section 2: Monthly Budget Please fill out your expenses and income for the last month under the Amount columns Mark an “X” in boxes that don’t apply to you Expense Amount Income Monthly Rent Earned Food Public Assistance (if yes indicate amount) Liabilities SSI/SSD Child Care/ Child Support Car Payment/ Transportation Amount Unemployment Veteran’s Benefits? Maintenance/Repairs TANF? Insurance Food Stamps Telephone Section Education expenses EAEDC Clothing/ Laundry / Dry Cleaning Scholarships Cable / entertainment Child Support Court costs / legal fees Boarders/Sublet Medical Expenses Other _ Other Total Expenses Total Income 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -6- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Section 3: Current Financial Situation Outstanding Debt Amount Back rent Other loans Credit card Other (auto payment, friends, family) Total Debt Do you have a personal savings or checking account? YES NO Type of account: Checking Savings Name of institution at which account is held: Section 4: Recent Work History Please include information for your three most recent employers Start/End Date Employer Job Title Wage Reason Lef 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -7- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Section 5: Questions for Applicant Please describe your current situation and how you ended up in your current situation Have you gone to any other service agencies for assistance? If yes, which ones and with what have you been provided? 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -8- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com How will you use a CEF loan? Please be as specific as possible, and continue writing on the back or attach a sheet of paper if more space is needed How will your purchases/investments help you to improve your current situation? 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -9- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Section 6: References Please list the names and contact information of at least two individuals who can serve as a reference Acceptable references are past or current landlords, case managers/advocates, other social service providers, and past employers Current CEF borrowers may be listed as a reference, but may only be used for one of the two required references TWO REQUIRED REFERENCES: Name Business/Agency Name _ Address Telephone _ Time Known Relationship to Reference _ Name Business/Agency Name _ Address Telephone _ Time Known Relationship to Reference _ ADDITIONAL REFERENCE: Name of family member or close friend Address Telephone _ Time Known Relationship to Reference _ 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -10- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Section 7: Informed Choice I declare that I have looked over this application as well as any attached documents and that all presented materials are truthful, correct, and complete I also hereby give the Community Empowerment Fund authority to check my credit with the understanding that any findings in this credit report will not automatically disqualify me from receiving a loan I also hereby give CEF the authority to call my references, providers, and/or employers that I have listed in this application Applicant Signature: Date: _/ _/ _ Printed Name: Loan Officer Agreement: I have read the above statements aloud with the applicant and have established informed choice with this applicant I have additionally gone through this application to make sure that all relevant questions have been answered and appropriate documents attached Loan Officer Signature: Date: _/ _/ _ Printed Name: Loan Officer Signature: Date: _/ _/ _ Printed Name: 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org ... filling out the application 180A E Cameron Ave, CB #5115 • Chapel Hill, NC 27599 • Tel: 919-200-0233 www.communityempowermentfund.org Loan Application -3- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com... 919-200-0233 www.communityempowermentfund.org Loan Application -9- UNC-CH Campus Y (919) 200-0233 thecef@gmail.com Section 6: References Please list the names and contact information of at least two... termination of the application CEF encourages clients to be as detailed as possible with their responses and to enclose additional information such as pay stubs or other income verification,