Financial Evaluation Form

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

ANGER MANAGEMENT SPECIALISTS

TEXT 805-242-2502

Please complete this form in FULL so we can assess a lower fee for you:
IMPORTANT:

You can not claim "$0" in expenses or income. You must declare some sort of funds you live on
Application will not be process if form is incomplete and no documentation is provided
Requesting financial aid does not mean program will be free. There will be a fee still but if you qualify, your fee will be lowered accordingly.
Completing financial aid does not mean you are enrolled in program. Enroll in program first if you haven't already.

If you work, what is your income/month? *

If you do not work, how much social aid do you receive? CalFresh, EBT, General Relief, other? *

Phone

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TO PRINT OR APPLY ONLINE

BELOW

Is your family or spouse helping you with rent? housing? food? *

Email: *

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Expenses per month (ex: Rent $1200, Food $80, Gas $60, etc) *

STEP 1- Show any of these documents as proof of income:
If you are employed, please send any statements below to amsbip (at) gmail.com:

If you are unemployed, homeless, residing in shelter, at in-patient, or disabled in any way: Show any statement of social aid

Do you look for work? and how often? Job search https://www.amspecialists.org/jobs-search.html *

STEP 3: APPLY Name: *

STEP 2: Upload document *