Financial Evaluation Form

court certified batterer intervention and anger management programs for Santa Barbara County

ANGER MANAGEMENT SPECIALISTS

ENROLL TODAY

TEXT 805-242-2502

IMPORTANT NOTE:

Requesting aid does not guarantee approval
Application will not be process if form is incomplete and without documentation
Must Enroll first. Completion of financial declaration form does not mean you enrolled.

Total $ spent monthly and description (example: Rent $$, Gas $$, Childcare $$ etc) *

Name: *

Upload any proof of income *

Total amount of money you receive per month and description (ex: CalFresh $$, Job $$, my family gives me $$ etc *

If you say you have "no income", please declare your spouse/partner level of income and/or social aid (ex: CalFresh $$, Job $$, etc *

If you are FULL TIME EMPLOYED, you probably will not qualify but if you believe that you can, please show:

If you are UNEMPLOYED, homeless, disabled, work comp, or retired, please show:

Email: *

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