PEWTW Auto Eligibility Form

Portland Electric Ways to Work Auto Eligibility Form

Thanks for your interest in the Portland E-WTW program! Please complete all questions to determine eligibility in the program. For eligible participants, MFS is currently offering an incentive towards the purchase of a vehicle: $5,000 off an electric vehicle, $4,000 off a plug-in hybrid electric vehicle, $3,000 off a hybrid vehicle, $500 off an electric bike.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
What type of vehicle are you interested in purchasing?*

Electric vehicle (EV)Plug-in hybrid electric vehicle (PHEV)Traditional hybrid vehicle (hybrid)Not sure yet, would like to learn more about the options
Please complete this eligibility form for the electric bike program.
You can view an infographic comparing these three vehicle types HERE
How did you hear about this program?*

Community Partner/CaseworkerCommunity EventDoorDashEV RidesFriend/familyOnline searchOther (please describe)
If community partner, please select which partner:

SEILatNetIRCONAYAHome ForwardPGEPacific PowerForthOther
If community event, please share which event:
If you have a car, what is your current car? (Make, model, year)*
What is your current job?*
How long have you been at your current job? (Ways to Work participants must have at least 6 months at their current job to participate in the program)*

0-5 monthsLonger than 6 months
If you have not been at your job for 6 months, how long were you at your previous job? And is there anything you would like us to know about your employment history?
How many hours do you work a week? If it varies each week, use the average hours per week. (Ways to Work participants must be working at least 30 hours a week to participate in the program)*

0-29 hours30 or more hours
Do you have a Portland address? (We are only able to serve Portland residents at this time)*

YesNoOther
Do you currently have stable housing?*

YesNo, please share more here:
Do you have a valid Oregon driver’s license or are in the process of obtaining one?*

Yes, Oregon driver's licenseYes, I am in the process of obtaining an Oregon driver's licenseI have another state driver's licenseNo, I do not have a driver's licenseOther
What is your current monthly income? (Ways to Work participants must have a household income less than 80% of Portland median family income.)*
How many people are in your household?*
Have you tried to get a car loan through a bank or credit union? If so, please tell us a little about what happened. If you have not tried, please tell us why not. *
Have you ever had a car repossessed? If so, please tell us when and what happened? *
Do you currently have any debt in collections? If so, please tell us about how much and a brief explanation of what is happening with it. *
Have you ever filed for bankruptcy? If so, what year and tell us what has changed since then. *
The goal of the Ways to Work program is to help people build their credit and financial assets. To reach this goal, a central part of this program is financial coaching. Are you willing to participate in financial coaching to get ready for the loan and also while you have the loan? *
It is important to understand that this program takes time and not all loans can be approved quickly. Do you understand it may take anywhere from 1-3 months or longer before you can be approved for a loan? *
Are you willing to work on saving money and pay down current debt (if applicable) while you get ready for your loan? *
Note that if you are eligible for this program, and you approve, we will do a soft credit pull (this will not negatively affect your credit score) and determine the next course of action depending on the results. We will still be able to work with you if you choose to get a loan outside of E-WTW (with another bank or credit union) as long as you meet the program criteria.
Please complete the following questions about your interest in electric or hybrid vehicles. This will not affect your eligibility. If you qualify for this program, an Electric Vehicle Coordinator will work with you to share information about available options and ensure you get the best vehicle for you.
1. Why are you interested in an electric/plug-in hybrid/hybrid vehicle?*
2. Please share any research about EVs or hybrids you have done. This could include reading information about EVs or hybrids, watching videos, test-driving one, talking to EV owners, etc. This program is designed for folks at every stage of the process, from completely new to electric and plug-in hybrid electric vehicles to those who have done independent research. *
Pricing and budget:

This program has a $12,000 maximum loan amount. You can then add on any personal savings and the MFS incentive: $3,000 off a hybrid, $4,000 off a plug-in hybrid, $5,000 off a fully electric vehicle.

You may also access up to an additional $4,000 in a federal tax credit for a used electric vehicle or plug-in hybrid. MFS will work with you to provide budget and financial coaching for the loan.

For a used EV: get up to $9,000 off the cost of purchase + up to $12,000 loan

For a used plug-in hybrid (PHEV): get up to $8,000 off the cost of purchase + up to $12,000 loan

For a hybrid: get $3,000 off the cost of purchase + up to $12,000 loan
3. With all the above in mind, what total price range of vehicle are you looking for?*

$0-$12,000$12,000-$17,000$17,000-$21,000$21,000-$25,000$25,000-$28,000$28,000+
4. Do you plan to put a down payment or savings towards your car? *
5. What do you plan on using your vehicle for? Do you need to transport children? Do you do any rideshare? Is cabin space and car size a factor? *
6. Approximately how many miles do you travel in a week?*
7. Do you do any long road trips (more than 200 miles one way)? *
8. Please describe your plan for charging an electric or plug-in hybrid electric vehicle (if you have thought about charging options). Do you know if you have access to home charging?*
9. Do you have any particular vehicles or models in mind? Are there any specific vehicles or models you would like to learn more about?*
10. What would be your ideal timeline for purchasing a vehicle through this program?*
11. Is there anything about electric/hybrid vehicles you would specifically like to learn more about? Do you have any hesitations/concerns?*
By sharing your information with us, you will help MFS better understand the resources needed for you and your family and our community. Your voice is important and we respect your family’s privacy. We will not share any personally identifiable information with anyone without your permission.
What is your race/ethnicity? (Check all that apply)*

AsianLatino/HispanicNative Hawaiian/Pacific IslanderBlackIndigenousSlavicMiddle EasternNorth AfricanWhiteDecline to answerPlease share your origin, ethnicity, ancestry, country of origin, race, and/or Tribal affiliations in whatever way you wish here:
What is your gender identity? (Check all that apply)*

ManWomanNonbinaryCisgenderTransgenderIntersexTwo SpiritDecline to answerOther
Please select your age range (you must be 18 or older to participate in E-WTW):*

0-1718-2425-4445-6465+
What is the primary language you speak at home?*

EnglishSpanishRussianCantoneseMandarinHmongKoreanVietnameseArabicOther (please list)
Thank you for completing this form. If you meet the eligibility criteria for the E-WTW program, we will contact you. If you would like us to know anything else, please share below.
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Portland Electric Ways to Work Auto Eligibility Form