Journey To Wealth Interest Form Complete this brief form below to start your Journey To Wealth with The Columbus Urban League: What is your First Name? * What is your Last Name? * Zip Code? * What is your Phone Number? * What is your Email Address? * Do you qualify for publicly funded programs? * —Please choose an option—YesNoUnsure Select Preferred Class Date *Cohort 5: May 30-June 20(1)Cohort 6: July 11-August 1(1)Cohort 7: August 15-September 5(1)Cohort 8: September 19-October 10(1)Cohort 9: October 24-November 14(1)Cohort 10: November 28-December 19June 18(2)July 16(2)August 20(2)September 17(2)October 22(2)November 19(2)December 17(2)July 21 (3)October 20(3)December 8(3) Date of Birth Age How did you learn about our program? From the Columbus Urban LeagueSearch Engine (Google, Yahoo, Bing, etc.)Friend/Family MemberAdvertisement (TV / Radio / Etc.)Newspaper/Magazine ArticleFacebook / TwitterDirect Mail UTJP-Eligibility (Select All Applicable) Unemployed (less than 27 weeks)Long Term Unemployed (greater than 27 weeks)High School GraduateVeteranMature Worker (Seniors)Full Time, Permanently Employed (Ineligible) Highest Education Status (Select One) NoneLess than High School (No Diploma Received)High School Graduate or EquivalencySome CollegeAssociates DegreeBachelor’s DegreeVocation License or credentialMaster’s Degree (May not be eligible)Post-Master’s Degree (May not be eligible) Documentation (Select All That Apply/Cannot Be Expired) PassportState Issued Photo IDBirth CertificateHigh School Diploma/Equivalent and/or College TranscriptsUnemployment Funded by a grant awarded by the U.S. Department of Labor's Employment and Training Administration. To assist you in making an appointment with our staff, please indicate the best time and method for us to contact you: Do you have a set closing date for the purchase of your home? if yes, please provide the date. if no, please leave blank. MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDay12345678910111213141516111213141516171819202122232425262728293031