FreeFrom

FreeFrom Savings Matching Program Intake Form

Introduction

Thank you for participating in FreeFrom's savings matching program. We are so excited to support you on your savings journey by matching up to $40 per month for 6 consecutive months!

If you have any questions about the savings matching program or this survey, please reach out to Dafne Jacobs (she/her), Manager of Survivor Programming at dafne.jacobs@freefrom.org.

A note on your participation and confidentiality:

Your privacy is our #1 concern. The responses you provide are password protected and will only be seen by the FreeFrom team. We will never share your personal information.

Aside from questions that will set you up to participate in the program, we ask a few additional questions so that our team can evaluate how savings matching benefits you and better understand your needs and experiences around saving.

We want to be completely transparent with you, so please be aware that FreeFrom may publish your anonymized responses in reports and/or advocacy materials. This means that we won't share your name or any other identifying information.
  • For example, if you share that you recently moved away from Austin, TX, where you lived with your harm-doer, to Spokane, WA to live with your sister, we would exclude your specific location and just say that you moved in with your sister.
By clicking "Next Page" below, you acknowledge that you have read the information above and are OK to proceed to the questions.
This can be your legal name, chosen name, or whatever name you want us to use. If possible, please use the same name every time you fill out a FreeFrom survey or application. We ask you to use the same name so we can match the surveys you take to your contact record in our system. However, we understand that asking folks to always use the same name may not feel affirming for those who are transitioning or recently changed their name. We want to give you the opportunity to use the name of your choice, so if you would like to update your name in our records, please contact Anakaren (AK) Alcocer at anakaren.alcocer@freefrom.org. 

Please note: if you want to receive your funds by check, make sure you can cash a check made out to the name you provide here.
This can be your legal name, chosen name, or whatever name you want us to use. If possible, please use the same name every time you fill out a FreeFrom survey or application. We ask you to use the same name so we can match the surveys you take to your contact record in our system. However, we understand that asking folks to always use the same name may not feel affirming for those who are transitioning or recently changed their name. We want to give you the opportunity to use the name of your choice, so if you would like to update your name in our records, please contact Anakaren (AK) Alcocer at anakaren.alcocer@freefrom.org. 

Please note: if you want to receive your funds by check, make sure you can cash a check made out to the name you provide here.



Thank you for your interest in the Savings Matching program. FreeFrom's mission is to support survivors in building the wealth and financial security they need to stay safe. Given the focus of our work, we are only able to provide this program to survivors of gender-based violence. We hope you are able to access alternative resources and support, and wish you safety and health.

Best regards,
The FreeFrom Team

Self-Evaluation Questions





Thank you for your interest!