Application Forms

APPLICATION FOR PARTICIPATION IN THE

2021 Your Money, Your Goals Cohort

OMB No. 3170-0068
Expiration Date: X/XX/XXXX

Important facts about the Your Money, Your Goals cohort:
- Training and technical assistance will be available to up to 40 organizations
- It is NOT a grant, contract, sub-contract, or funding to organizations
- Applications due X/X/20XX
The Consumer Financial Protection Bureau (CFPB) will provide Your Money, Your
Goals toolkits, training, and technical assistance to up to 40 organizations across
the country that are committed to helping financially empower the populations they
serve. The CFPB will support chosen organizations in the 2021 cohort, with 1) Your
Money, Your Goals and related financial empowerment and consumer education
materials; 2) Training tailored to each organization to prepare staff, volunteers, or
other community partners to use and to train others on the use of the tools and
resources included in Your Money, Your Goals; and 3) Technical assistance to help
each organization integrate financial empowerment and capability strategies into
their existing delivery model. Training and technical assistance will be provided
through a CFPB-contracted vendor.
The toolkit and other materials are available in English and Spanish on our website
(consumerfinance.gov/your-money-your-goals). When combined with the training,
these materials provide resources that staff and volunteers need to help people set
goals, choose financial products, and build skills in managing money, credit, and
debt.

If you are selected, the Bureau will provide the following:
▪ A Train-the-Trainer event (in-person or via webinar) led by specialized trainers and/or CFPB staff for
designated members of the organization’s team. These designated trainers would then lead workshops
for frontline service providers, volunteers, or community partners to help them use Your Money, Your
Goals in their work. In some organizations, these individuals may have or take on a formal training role.
In others, they may be informal leaders, champions and mentors who share resources and motivate
their colleagues to learn about and use the tools.
▪ Hard copies of the toolkit and other Your Money, Your Goals materials for the staff/ volunteers the
organization trains.
▪ Technical assistance in determining training priorities and adapting materials to the unique needs
and context of the organization or program.
▪ Coordination calls for all cohort participants at key points during the year to promote peer learning,
support and to share promising practices.
Consumer Financial
Protection Bureau

Applications due X/X/XXXX 1 of 6

YOUR MONEY, YOUR GOALS COHORT APPLICATION FORM

To participate
The CFPB anticipates that training and technical assistance will begin in January 2021 and conclude in
December 2021.
Your Money, Your Goals is designed for organizations that serve low-income and/or economically vulnerable
people. The tools and training approach is designed for organizations and frontline staff that have one-on-one
interactions with vulnerable consumers. While the materials may be used in wide variety of settings, past
participants have generally been most successful in integrating the tools if they work in a setting that allows them
repeated, direct contact with consumers over a period of time. Other criteria for the cohort include:
•

Commitment to integrating financial empowerment into their work. Demonstrate an understanding of
the benefit of helping the people you serve become more financially capable and how their increased
financial capability may help them achieve their goals and the outcomes your organization’s services
support.

▪ Staff capacity for training on and use of the Your Money, Your Goals toolkit. Demonstrate
capacity to dedicate staff time to provide support or assistance and lead training of other staff
within the organizations and/or other partners within your community.
▪ Staff capacity to use toolkit with clients. Demonstrate capacity to commit staff or volunteer
time to using the Your Money, Your Goals toolkit with low-income and/or economically vulnerable
populations.
▪ Commitment to fulfill survey collection responsibilities. This includes collecting and returning
training surveys to the CFPB’s contracted vendor for compilation of data.
We are interested in engaging organizations with a variety of capacities and approaches. We welcome
both organizations experienced in the work of financial empowerment and those interested in learning
how to integrate financial capability topics into their work to increase the value of their existing services.
As you consider how you would implement Your Money, Your Goals, you may find the Your Money,
Your Goals Implementation Guide helpful. It contains detailed information on the process of planning
training workshops, considering how to integrate use of the tools into your work (including links to indepth integration resources created by the U.S. Department of Health and Human Services), and
understanding how you can use CFPB’s Financial Well-being Scale with the people you serve.

Consumer Financial
Protection Bureau

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YOUR MONEY, YOUR GOALS COHORT APPLICATION FORM

Privacy Act Statement
The information you provide, including contact information, will only be used for managing participation in financial
empowerment initiatives sponsored by the Consumer Financial Protection Bureau (CFPB). The financial empowerment
initiatives are opportunities for public and private organizations or entities to receive tools, training, technical assistance,
and other services to help them reach low-income and economically vulnerable consumers. Identifying information
collected may be used by and disclosed to employees, contractors, agents, and others authorized by the Bureau to
receive this information to assist in related activities.
Information collected by the CFPB will be treated in accordance with the System of Records Notice (“SORN”), CFPB.021 –
CFPB Consumer Education and Engagement Records, 83 FR 23435.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and 1022, codified at 12 U.S.C.
§§ 5493 and 5512.
Your participation is voluntary, and you may withdraw participation at any time. You are not required to submit or provide
any identifying information; however, not doing so may result in the Bureau being unable to fulfill your request.

Paperwork Reduction Act Notice
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and not withstanding any
other provision of law a person is not required to respond to a collection of information unless it displays a valid OMB
control number. The OMB control number for this collection is 3170-0068. It expires on xx/xx/xxxx. The time required to
complete this information collection is estimated to average approximately 3 hours per response. Comments regarding
this collection of information, including the estimated response time, suggestions for improving the usefulness of the
information, or suggestions for reducing the burden to respond to this collection should be submitted to the Consumer
Financial Protection Bureau (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].

Consumer Financial
Protection Bureau

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Applications due

YOUR MONEY, YOUR GOALS COHORT APPLICATION FORM

X/XX/202X

Organization information

1

Please provide
your organization’s
contact information

ORGANIZATION NAME

ADDRESS

CITY

POINT OF CONTACT NAME

STATE

ZIP CODE

EMAIL

WORK PHONE

(Box for job title)
ADDITIONAL POINT OF CONTACT NAME (OPTIONAL)

ADDITIONAL POC EMAIL

2

What is your
organization’s
mission and vision?

MISSION

VISION

3

Describe your
organization’s
geographic service
territory and the
populations it
serves

Consumer Financial
Protection Bureau

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YOUR MONEY, YOUR GOALS COHORT APPLICATION FORM

Your organization and its plans for Your Money, Your Goals

4

5

Describe your
understanding of
and commitment
to this project’s
goals, including
how this project
links to
outcomes you
currently track
for your
organization and
program
participants.

Describe how
your
organization’s
staff members or
volunteers
typically interact
with vulnerable
consumers or
clients. Check all
that apply:

-

One-on-one meeting or conversation with an individual, with minimal
to no follow up

-

One-on-one meeting or conversation, with some follow up at regular
intervals

-

Regular on-on-one meetings over a period of six months or more

-

Group sessions/classes or interaction that is not one-on-one

-

A combination of one-on-one meetings and classes or other group
settings

Other – _____________________________________________________________________

6
6
6

Describe your
organization’s
existing service
model and how
financial
empowerment will
be integrated into
it.

Consumer Financial
Protection Bureau

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YOUR MONEY, YOUR GOALS COHORT APPLICATION FORM

7

Describe your
organization’s
capacity to
undertake this
project, including
availability of
administrative
support and a
designated staff
member who will
leading its
implementation.
Will this be will
be integrated
into ongoing
staff/ volunteer
training?

Consumer Financial
Protection Bureau

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YOUR MONEY, YOUR GOALS COHORT APPLICATION FORM

Project goals

7

How many individuals will participate in the CFPB-led trainthe-trainer and then lead workshops for or equip other staff
and volunteers to use the materials?

8

Within the next year, how many workshops for frontline staff,
volunteers, or community partners will your trainers lead? Do
not include workshops for clients in this total.

workshops

9

Within the next year, how many frontline staff or volunteers
from your organization and/or
from community partners does your organization plan to train?

partners

10

Within the next year, how many clients will your organization reach
using Your Money, Your Goals resources?

clients

trainers

Information sharing

11

Can your organization commit to administering pre- and post-surveys to all
participants of trainings your organization will hold and to share those surveys
with the Bureau?

YES

NO

Submission instructions

▪

Completed application

▪

IRS Form 990

▪

Accessibility Policy

▪

Annual Report

▪

Most recent financial audit

▪

Nondiscrimination Policy

Email

[email protected]

Consumer Financial
Protection Bureau

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