Financial Coaching Inquiry Form
Please fill out this form if you are interested in seeking
financial coaching
with us. One of our coaches will reach out to you with next steps. If you are seeking tax help, please go here:
https://www.justastart.org/freetaxprep/
What brings you to us for Financial Coaching? (choose the option that is of the highest priority to you right now)
Financial Coaching Highest Need
Budget counseling
Credit counseling
Goal setting
Immediate-need counseling
Other Assistance
Contact Information
First name:
Last name:
What is your preferred method of communication?
Phone
Email
Text
Home Phone (If applicable)
Mobile Phone
Email address:
Address
Start typing you full address including city in the
Type address field
below and select the correct option. The city, state and zip code will auto-populate.
Start Typing full address here:
City:
State
Zip Code:
Just-A-Start resident?:
Yes
No
Other Information
Estimated Household Income (e.g. 40,000)
The total income of everyone in the household.
# of people in household
Race (please check all that apply)
African American/Black
Asian
Hispanic/Latinx
White
Native American/Alaskan
Native Hawaiian or Pacific Islander
Other
Decline To Disclose
Ethnicity:
Hispanic/Latinx
Non-Hispanic
Decline to Disclose
Date of Birth:
Gender:
Please select...
Female
Male
Transgender
Nonbinary
Other
How did you hear about us? (Select all that apply):
Cambridge Employment Program
Cambridge Housing Authority Flyer
Cambridge Learning Center
Cambridge Multi-Service Center (MSC)
CEOC (Cambridge Economic Opportunity Committee)
Current or Former Participant
Friend or Relative
Greater Boston Legal Service Center
Just A Start Website/Internet Search
Just A Start Housing Flyer
Just A Start Presentation
Just A Start Staff
Justice for Housing
MassHire Website
Other
Social media
VITA tax preparation client
Word of mouth
If Other, please specify:
Contact Information