What do you hope to achieve within the next 3 years with Social Income?

Where do you live?

What is your marital status?

Do you have any dependents?

How many people depend on you financially?

Are you currently attending school?

What is your current employment status?

Are you currently looking for work?

Do you have a disability or illness that affects your possibilities of getting work or keeping your job?

Do you or other family members in your household ever skip meals because there wasn't enough money for food?

Did this happen last week?

Did you skip more than 3 meals in the past week?

Do you have enough money to cover unexpected expenses like seeing a doctor?

Are you currently able to save money?

Are you in debt?

Are you able to repay the debt?

Is anyone in your household in debt?

Are you the main person repaying the debt?

Are you currently receiving any other form of financial support from anywhere else?