Intake Application

Providing Small Loans to Assist Family Self-Sufficiency. We will assist you in obtaining loans up to $1000.00 for car repairs and up to $4,000.00 for a car purchase.
Ways to Work Intake Application
You must meet all of the following guidelines to be eligible to participate in the Ways to Work program.
  • Valid Pennsylvania Driver's license
  • Must need a vehicle to get to work
  • Must be working continuously for 6 months or more, at least 20 hours per week
  • Must live in Armstrong, Allegheny, Beaver, Butler, Fayette, Washington, Westmoreland, Greene or Fayette County
  • Must be an involved parent of a dependent child 18 years or younger still in school
  • If you need a car for educational purposes, you must also meet the work requirements
  • Must demonstrate willingness and ability to make a modest monthly payment
  • Must fall within the following eligibility guidelines:
Family Size    Yearly Income (Allegheny, Beaver, Butler, Fayette, Washington and Westmoreland Counties.) Yearly Income (Armstrong &Greene County)
2 $37,050.00 $32,400.00
3 $41,650.00 $36,450.00
4 $46,300.00 $40,500.00
5 $50,000.00 $43,750.00
6 $53,700.00 $47,000.00
You can submit this preliminary application on-line or print it out, complete it and mail to address at bottom of page.
For what purpose will this loan be used? (check only one) Car Purchase Car Repair Other
Name 
Address
City
State
Zip Code
County
Phone
E-mail
Home Phone
Work or Cell Phone
Spouse:
Minor Children? Yes    No   Total number living in your household:
Age of Children:
Working Currently? Yes No If yes, hours per week:  How long at current job?
Name of Employer
Employer Address
How are you currently getting to work/school? Check only one:
Own car (List Year, Make, Model, Mileage and vehicle problems):
Rides from friends/co-workers/neighbors/family
Borrowing someone's car (spouse/neighbor/relative)
Transportation Program
Public Transportation
Do you have a valid Pennsylvania driver's license? Yes No
How does your credit look right now? (e.g., "Good", "Bad"...)
Have you ever had a vehicle repossessed, a foreclosure on property, or filed bankruptcy? Yes  No
Gross Monthly Income:
Are you financially able to make a small monthly car payment? Yes No    If yes, how much: $
Are you receiving Food Stamps?  Yes    No
Do you receive Public Assistance in the form or cash? Yes    No
Are you enrolled in a educational program?  Yes    No
In what field of study?
When will you complete it?
How many credits are you carrying?
f you meet all the requirements you can Print a Ways to Work application and return it in the mail to the address on the application. We will not accept a faxed copy.

Family Services of Western Pennsylvania

Ways to Work Program

6401 Penn Avenue, 2nd floor

Pittsburgh, Pennsylvania 15206

 1-886-5929 (Toll Free) or 412-661-1670 650

Fax: 412-665-8730

 

 

Please contact me as soon as possible regarding this matter.

Further assistance and information is available through the Family Services of Western Pennsylvania administrative office at (412)-820-2050.

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