Money Talks

Money Talks

The program application must be completed by a parent/guardian and students.
Get a head start on your financial future! This interactive course introduces high school students to the essentials of financial literacy — from budgeting and saving to credit, investing, and understanding paychecks. Students will gain the tools and confidence to make smart financial decisions now and in the future. Whether you’re preparing for college, your first job, or just want to learn how money works, this program will help you build a strong financial foundation.
STUDENT INFORMATION
Student Name*

First NameLast Name
Student Date of Birth*

MonthDayYear
Student Email*
example@example.com
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Gender*

FemaleMaleOther
School Name*
Grade*
Student Ethnic Origin*

American Indian/Alaska NativeAsianBlack/African AmericanNative Hawaiian/Pacific IslanderWhiteTwo or More RacesPrefer not to say
How confident are you about managing money?*

Very confidentSomewhat confidentNot confident
How often do you think about money or budgeting?*

All the timeSometimesRarelyNever
What do you want to learn most about financial literacy? (Select all that apply)*

How to budget and save moneyUnderstanding credit and debit cardsHow to open a bank accountHow to invest or build wealthHow to pay for college
How taxes workHow to manage money from my first jobOther: __________________________
Do you currently have a savings or checking account?*

Yes, bothOnly a savings accountOnly a checking accountNo
What does “financial literacy” mean to you?*
What’s one financial goal you’d like to reach in the next few years?*
What do you hope to get out of this program?*
Please note: Y-USA requests the above information from YMCA participants throughout the nation for program funding and demographic purposes.
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name*

First NameLast Name
Relationship to Student*
Parent/Guardian Date of Birth*

MonthDayYear
Parent/Guardian Phone Number*
Parent/Guardian Email*
example@example.com
Address (If different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMERGENCY CONTACT INFORMATION
Do you want to provide Emergency Contact information for the student that is different from the Parent/Guardian information provided above?*
Name

First NameLast Name
Relationship to Student
Phone Number
Address (If different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Code of Conduct Agreement*
Waiver & Release of Liability*
Please confirm you are not a robot*
Student Signature

Clear
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: