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Glenwood School Savings Program

Caddo Hills Elementary School

Kirby Elementary School

Centerpoint Elementary School

Start your elementary student on the right financial track by enrolling them in our School Savings Program.

To Enroll in the School Savings Program:

CLICK HERE to download the enrollment form ~OR~ just come into our Glenwood branch to take care of it all.

Email the completed enrollment form with a copy of your driver’s license to Tamara.Horn@banksouthern.com ~OR~ return these documents to your child’s school.

Complete the documents (signature card and arbitration agreement) which will be provided to you (via school).

Get your child ready to start saving on your school bank day!

School Banking Days

Coming Soon!

Have questions or need more information?

Contact Tamara Horn at 870.356.8969 or complete this form:

"*" indicates required fields

Step 1 of 5

20%

Required Enrollment Documentation

To complete this form, you will need the following documentation. Scans or photos of documents are acceptable but all information must be clear and readable. Unclear, blurry, or partial scans or photos are not acceptable and may delay your application process.

Required Documents:

Driver's License or photo ID
Proof of Citizenship (one of the following):
- Social Security Card or
- Certificate of naturalization or
- Certificate of citizenship
Family Status (proof of at least one dependent under the age of 18)
- Birth Certificate or
- Tax return with dependent(s)
Annual Income (Income must be verified to determine eligibility) Please provide at least one of the following:
- Pay stubs (4) showing year to date earnings
- W2 form
- Most recent tax return
- Employment contract
- For self-employed individuals - forms of income verification acceptable to the IRS
- For unearned income, verification from the source
Banking and Investments (one copy of latest statement)
- Most recent checking and/or savings account statement
- Most recent investment statement (401K, IRA, other investments)
Proof of Current or former TEA/TANF (only if applicable; Not a program requirement)
Current Low-Income Determination (If applicable)
- SNAP
- TEA
- SSI
- LIHEAP
- Free/Reduced Lunch
- Women, Infant, Children (WIC)
- Housing and Urban Development (HUD), Section 8 or Public Housing

New Participant Application Form

Participant Social Security Number:*

Date of Birth:*

MM slash DD slash YYYY

Name*

First Middle Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Number:*

Email Address:*

Please upload your Driver's License and Social Security Card:

Drop files here or

Max. file size: 22 GB.

.pdf, .png and .jpg file types preferred. If unable to submit documentation using this form, please complete form and submit documentation via email to IDA@banksouthern.com with your name in the subject line.

Participant Agreement - ADWS IDA Program

Hidden

Please check each statement indicating you understand and agree:*

I have watched the full video on IDAs at BankSouthern.com/IDA

Please check each statement indicating you understand and agree:*

I agree to open an IDA with Southern Bancorp.

*

I will receive a monthly bank statement and agree to share my account information with SBCP.

*

I must save at least $667, and understand that every $1 that I deposit in my IDA up to that amount will be matched by $3.

*

I understand that I will receive no more than $2,000 in total match funds.

*

I must complete my required savings before the match funds may be accessed.

*

I understand that I must save for at least 6 months before I can receive the matched funds.

*

I understand that my IDA savings and my match funds will be kept in separate accounts.

*

I understand that matched funds will be distributed directly to service providers or vendors and not to the participant.

*

I will receive a monthly IDA statement reflecting the current match and savings balance.

*

I understand that Southern Bancorp Community Partners may contact me during the program or after completion to gauge my satisfaction in understanding the impact of the program

Allowable Asset Purchases (Select One)*

Homeownership (down payment, closing costs, etc.)

Critical Need Home Repair(s)

Business (New or existing business expenses)

Post-Secondary Education (tuition, required school expenses, certifications, etc.)

Financial Education and/or Credit Counseling*

I understand that a minimum of three hours of financial education coursework is a requirement of the IDA program and must be completed before matched funds are distributed.

Release from Liability*

During the course of program participation, SBCP and/or its program partners may provide advice and consultation on personal finance matters. This advice shall be based on the best and most current available information; however, SBCP and/or its program partners accept no liability, financial or otherwise, for personal actions taken by the program participant. Full and complete responsibility for all personal financial actions rests solely with the IDA program participant.

I agree to the liability release.

Qualified Account Withdrawals

Qualified withdrawals are only available for the program's stated permissible uses after completion of all program requirements.

When I am ready to purchase my asset I will contact an IDA program coordinator via email or by phone in order to submit all required documentation.

Funds will be written by check to the vendor. There are other methods of payment that can be made and will be determined on a case by case basis.

I agree to the Qualified Account Withdrawals.

Asset Purchase Agreements

Homeownership*

Provide the "Loan Estimate" or contract showing all costs associated with the home purchase, which will be used to request the match check.

Participant is an owner or co-owner on the home.

Provide a completed, notarized sales and purchase agreement. Documentation should contain the legal description and language as to the conveyance of the property, for a home that is being owner-financed.

Check(s) will be issued to the vendor(s) presented on the invoice provided by the program participant.

I agree to the Homeownership Statements.

Home Repair*

Must be the owner or co-owner of their primary residence and provide proof.

Funds can be used for major appliance replacement due to wear and tear: hot water heater, air conditioning unit, stove and/or must make the home more energy efficient.

Funds can be used for home improvements or repairs.

Present a minimum of two written cost estimates for each repair work to be done along with a W9 from the person performing the work outlined in the estimate.

Check(s) will be issued to the vendor(s) presented on the invoice provided by the program participant.

I agree to the Home Repair Statements.

Small Business*

Must provide a business plan describing the business, and plan for the use of funds.

A W9 will be required for invoices from contractors and local businesses.

Check(s) will be issued to the vendor(s) presented on the invoice provided by the program participant.

I agree to the Small Business Statements.

Post-Secondary Education/Workforce Training*

Must provide a class schedule.

Must provide current tuition statement.

Must complete SBCP's Education Plan spelling out their education and career plan.

Check(s) will be issued to the vendor(s) presented on the invoice provided by the program participant.

I agree to the Post-Secondary Education/Workforce Training Statements.

IDA Participant Statistics

Gender:*

Male

Female

Marital Status:*

Single

Married

Separated

Divorced

Widowed

Ethnicity:*

African American

Asian or Pacific Islander

Caucasian

Latino or Hispanic

Native American

Place of Residence:*

Urban (2,500 or more)

Small town or rural (less than 2,500)

Highest Level of Education Completed:*

How many adults (18 years and older) currently live in participant's household?*

How many children (under 18 years) currently live in participant's household?*

Please upload proof of dependents under the age of 18:

Drop files here or

Max. file size: 22 GB.

Proof of dependent documents accepted: Birth certificate(s) or tax return with dependent(s) .pdf, .png and .jpg file types preferred. If unable to submit documentation using this form, please complete form and submit documentation via email to IDA@banksouthern.com with your name in the subject line.

Employment Status:*

Did you have an existing relationship with Southern Bancorp Community Partners prior to enrolling in the IDA program?*

Yes

No

Unknown

If yes, please explain:*

Who was your referral source?:*

Have you ever received TANF or TEA?*

Yes

No

Unknown

Are you presently a TANF recipient?*

Yes

No

Unknown

Please upload proof of current or former TEA/TANF Documents:

Drop files here or

Max. file size: 22 GB.

.pdf, .png and .jpg file types preferred. If unable to submit documentation using this form, please complete form and submit documentation via email to IDA@banksouthern.com with your name in the subject line.

Do you presently receive SSI or SSDI?*

Yes

No

Unknown

Do you currently receive food stamps?*

Yes

No

Unknown

Will you use direct deposit for your IDA?*

Yes

No

Unknown

Do you have health insurance?*

Yes

No

Unknown

Do you have life insurance?*

Yes

No

Unknown

Personal Financial Statement

Do you own a vehicle?*

Yes

No

Year, Make, and Model of Vehicle:

Value of Vehicle (in $):

Amount of Monthly Payment:

Do you own a home?*

Yes

No

Market Value of Home (in $):

Amount of Monthly Payment:

Do you rent your home?*

Yes

No

Amount of Monthly Payment:

Do you own a business?*

Yes

No

Value of Business (in $):

Do you own residential property or land?*

Yes

No

Value of Property (in $):

Do you own stocks, bonds, 401k or other investments?*

Yes

No

Value of Investments (in $):

Please Upload a Copy of your Most Recent Investment Statement:

Drop files here or

Max. file size: 22 GB.

.pdf, .png and .jpg file types preferred. If unable to submit documentation using this form, please complete form and submit documentation via email to IDA@banksouthern.com with your name in the subject line.

Do you have a checking account?*

Yes

No

Amount in Account (in $):

Please Upload a Copy of Your Most Recent Statement:

Drop files here or

Max. file size: 22 GB.

.pdf, .png and .jpg file types preferred. If unable to submit documentation using this form, please complete form and submit documentation via email to IDA@banksouthern.com with your name in the subject line.

Do you have a savings account?*

Yes

No

Amount in Account (in $):

Please Upload a Copy of Your Most Recent Statement:

Drop files here or

Max. file size: 22 GB.

.pdf, .png and .jpg file types preferred. If unable to submit documentation using this form, please complete form and submit documentation via email to IDA@banksouthern.com with your name in the subject line.

Do you owe money to friends and family?*

Yes

No

Amount Owed (in $):

Do you have past due household bills?*

Yes

No

Amount Owed (in $):

Do you owe money on credit cards?*

Yes

No

Amount Owed (in $):

Do you owe money on student loans?

Yes

No

Amount Owed (in $):

Do you owe money on medical bills?*

Yes

No

Amount Owed (in $):

Do you have any other bills not listed?*

Yes

No

Amount Owed (in $):

Total Assets:

Total Liabilities & Payments:

Personal Financial Statement (Continued)

How many household members do you have (including yourself)?:*

Self Monthly Income (in $):*

Self Annual Income (in $):*

Household Member Monthly Income (in $):*

Household Member Annual Income (in $):*

Household Member Monthly Income (in $):*

Household Member Annual Income (in $):*

Household Member Monthly Income (in $):*

Household Member Annual Income (in $):*

Household Member Monthly Income (in $):*

Household Member Annual Income (in $):*

Household Member Monthly Income (in $):*

Household Member Annual Income (in $):*

Household Member Monthly Income (in $):*

Household Member Annual Income (in $):*

Household Member Monthly Income (in $):*

Household Member Annual Income (in $):*

Total Monthly Household Income:*

Total Annual Household Income:*

Monthly Gross Income of Participant Household by Income Source

Formal Employment (in $):

Self Employment (in $):

Investment Income (in $):

Government Assistance (TANF, food stamps, SSI, Social Security, Unemployement benefits, Veteran's Benefits) (in $):

Child Support/Alimony Payments (in $):

Friends or Family (in $):

Other, please specify (in $):

Annual Income Documents

Please provide documents for all sources of income you receive:

Drop files here or

Max. file size: 22 GB.

.pdf, .png and .jpg file types preferred. If unable to submit documentation using this form, please complete form and submit documentation via email to IDA@banksouthern.com with your name in the subject line.

Personal Financial Statement Consent*

All information provided regarding my personal finances is to the best of my knowledge true as stated. I understand that I will be requested to fill out a personal financial statement 1 year after my asset purchase. I agree to complete the form and return it to the IDA office.

I agree to the personal financial statement

IDA Goal Statement

Asset Goal:*

Homeownership/Repair: Describe the type of home your family needs (A house? Condominium? Mobile home?) How many bedrooms? How many square feet?*

How much do you estimate the home/repair you need might cost? (in $):*

Small Business Start-Up or Expansion: Describe the business that you would like to start or expand (What product or service will you sell? What will your market be? Your competition?):*

How much do you estimate it will cost to start or expand your business? (in $):*

Post-Secondary Education: Describe the program you wish to enroll in (At what school? What type of degree or credential will you earn? How many courses required?):*

How much do you estimate it will cost to complete this program? (in $):*

IDA Action Plan

Long Term Goal:*

What is the amount you want to save each month (in $):*

Six months savings goal (in $):*

What action will you take in order to save this amount each month?:*

What do you think are the barriers to do this?:*

What can you do to overcome these barriers?:*

If there are problems on your credit report, now is the time to begin correcting them. What steps will you take to begin working on past debt problems?*

IDA Program Participant Signature

Signature*

NOTE: This field is only a text field in test, but we have the actual signature field capabilities in the live environment.

Date*

MM slash DD slash YYYY

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