Ways to Work application

Ways to Work Loan Application

There is no charge to apply. Simply fill out the required information below and hit submit.

Applicant Information
First & Last Name:
Social Security #:
Date of Birth:
Address Street :
City/Parish:
Zip Code:	(5 digits)
State:
All Others Living in Your Home
Name, relationship, age & school:

Contact Information
Daytime Phone:
Evening Phone:
Email:
Financial Information
Loan Type:
Is there a claim, suit or judgement against you?	Yes
Have you declared bankruptcy?	Yes
Was bankruptcy discharged?	Yes
Child Support monthly amount:
AFDC monthly amount::
Housing assistance monthly amount::
Other assistance monthly amount::
Food stamps monthly amount:
Current Employment Information
Employer/School:
Name of Employer/School:
Occupation:
Avg. Hours per week:
Work Phone #:
Date Hired:
Net Monthly Income::
Gross Monthly Income::
Avg. hours/week:
Other Information
Comments:	Enter comments here!
	I authorize Family Service of Greater Baton Rouge to verify my credit and employment history.