This page is for agencies and employers who would like to refer someone in need of assistance to Wheels of Success. Please read the eligibility guidelines to see if your referral qualifies. Then submit the appropriate application below for online processing.

Note: Applicant must be working or have a verifiable job offer.

Client Referral Application by Agency
Client Referral Application by Employer

This page is for agencies and employers who would like to refer someone in need of assistance to Wheels of Success. Please read the eligibility guidelines to see if your referral qualifies. Then submit the appropriate application below for online processing.

Note: Applicant must be working full time or have a verifiable job offer.

Client Referral Application by Agency (check back in May '08)
Client Referral Application by Employer (check back in May '08)

Eligibility Guidelines

INCOME:
Up to 250% above poverty level and not receiving government assistance other than:

• Unemployment Compensation
• Medicaid
• Food Stamps

STATUS:
Must be employed or unable to return to work due to transportation issues. Proof of employment required via one of the following forms:

• Employer verification
• Pay stubs (2) verifying employment
• W2 form from the previous year
• Offer of employment

CATEGORIES:

• Families with Child(ren)—Single Parent (Mother or Father) or an underemployed Couple with Child(ren)
• Underemployed Working Poor who have no dependent children
• Moderate Income Families who have no liquid resources and have suffered a catastrophic incident such as:
  • abusive relationship
  • accident
  • death of spouse
  • divorce
  • illness
  • loss of income

STIPULATIONS:

• Must sign contract giving their verbal commitment to remain employed/or notification of termination (with reason).
• Must agree to pay it forward a monthly set amount, based on income and 5 service hours per month
• Must provide valid Florida driver's license
• Must provide proof of insurance (if applicable).
• Optional agreement to provide public testimonial

REFERRALS:
Must be referred by one of the following sources:

• Social Service Agencies
• Churches
• Employers
• Board Members

Applicants to be approved by Guideline Committee Named by Board of Directors.