FSS Goal Sheet Form Name* First Last Address*Phone*EmailWho is your FSS caseworker?*Zoe ParakuoEverett BrubakerI'm not sureFSS Monthly Goal SheetThe FSS Goal sheet is a required part of the program, due every month by the 10th. The Goal sheet is there to communicate with your caseworkers, check in on your goal progress, and request any help with your goals or family needs. Questions? 540 437 9545 Goal Sheet MonthJob/Employer*Put "not working" if unemployed Hours per week*If not working what is keeping you from working?Home TasksCheck all that apply Paid rent on time Keeping my unit and outdoor spaces clean Managing my money Are you struggling with rent, keeping unit clean, or budget?Do you want to meet with your caseworker to make a savings and spending plan? Yes Not right now Classes I am currently takingPlease list all classes you are currently taking or enrolled in and the time frame. Classes I am interested inPlease list any classes you are interested in. We are happy to help with enrollment, finding scholarship, and more! Escrow Savings AccountDo you have any question about the escrow savings account? Goals and Action Steps*Please write your 2 or 3 main program goals. Next to each, please write what step you will take this month to get closer to that final goal. End of FormAny questions or comments?Signature*Today's Date Date Format: MM slash DD slash YYYY Upload Document or PictureYou can upload a document, picture of goal sheet, or anything else.