Newgate School Wheels for Women Application

You're a hard-working single mother in Minneapolis, MN, who has her family on the road to self-sufficiency. Let us provide a reliable car to help you get there. Complete the application below to register for the Newgate School Wheels for Women program.

Your Information

Full Name

Phone

Note: We can only accept applications from Minnesota for the Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington counties. Submissions from other areas will be rejected.

Address

City

State

ZIP Code

County

Is this address a shelter?

List your valid Minnesota Driver's License number

Children

Number of children you have under 18 living with you

Names and ages of your children under 18 living with you

Assistance

Are you currently receiving government assistance or subsidies?

List the names of subsidies and amounts of each

Employment

Name of employer

Address of employer

Employer or Supervisor name

Employer or Supervisor email

Employer or Supervisor phone

Date you started working with this employer

Monthly net take home income

Average number of hours worked per week

Education

Are you currently enrolled in school working towards a degree or certificate?

Name and address of school

Degree or program you are working on

Advisor name

Advisor email

Advisor phone

Referral

Please list a professional referral that we can call to verify some or all of the above information. We ask that you do not list a relative.

Referral name

Professional position

Phone

Tell us More About Your Situation

Please give a brief explanation of your current situation and why you are in need of a vehicle

Would you be open to a short interview and a photograph for our website?

Your Wheels for Women Application has been submitted!

Thank you for submitting an application for the Newgate School Wheels for Women program! We review all applications before selecting a recipient. You'll hear from us with the results. Applications are reviewed the month after they are received.

Thank you for your interest - We're wishing you the best of luck!