THANK YOU for your interest in Light The Way

Please fill out the following application, and someone from our team will be in touch!

Light The Way - Application

Name

First Name

Last Name

Phone

(###)

###

####

Marital Status

Military Status

Were you ever discharged from the military?

Employer Information

If you are unemployed put N/A

Employer Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

HAVE ANY MEMBERS OF THE HOUSEHOLD EVER BEEN CONVICTED OF OR BEEN CHARGED WITH A CRIME? (IT COULD BE AS SIMPLE AS A MISDEMEANOR DRIVING VIOLATION OR AS SERIOUS AS ARMED ROBBERY.) WE DO EXTENSIVE BACKGROUND CHECKS.

HAS THE FAMILY OR ANYONE IN THE FAMILY BEEN INVOLVED IN A LAWSUIT?

HAS THE FAMILY OR ANYONE IN THE FAMILY FILED FOR BANKRUPTCY?

HAVE ANY MEMBERS OF THE HOUSEHOLD BEEN ON TELEVISION?

DOES ANYONE IN THE HOUSEHOLD HAVE A FACEBOOK, BLOG OR WEB SITE OF ANY KIND?

HAS ANYONE IN THE HOUSEHOLD PARTICIPATED IN VOLUNTEER WORK OR COMMUNITY SERVICE OF ANY KIND?

HAVE ANY HOUSEHOLD MEMBER'S ACHIEVEMENTS OR PROUDEST ACCOMPLISHMENTS BEEN RECOGNIZED BY YOUR COMMUNITY?

LIST ALL VEHICLES OWNED AND OPERATED BY HOUSEHOLD MEMBERS (INCLUDING YOUR OWN):

HOUSEHOLD INCOME*

APPROX. NET WORTH*

LIST ALL CREDIT CARD AND LOAN ACCOUNTS:

ARE ALL LOAN PAYMENTS CURRENT?

LIST ALL RECIPIENTS OF STATE AID FOR FOSTER CARE, DISABILITY, ADOPTION SUBSIDY OR OTHER BENEFITS:

WHAT TYPES OF INSURANCE DO YOU HAVE:

WILL W2S AND/OR TAX RETURNS FOR THE LAST TWO YEARS BE AVAILABLE? (PLEASE DO NOT INCLUDE THEM NOW)

DOES THE FAMILY OWN A HOME?

LIST ALL LIVING EXPENSES BY EXPENSE TYPE:

LIST ALL OTHER PROPERTIES OWNED BY PROPERTY TYPE:

SUMMARIZE THE FAMILY'S CURRENT SITUATION. WHAT MAKES THEM DESERVING? WHAT MAKES THE SITUATION UNIQUE?