Work 'n Wheels Program Application Forms

You may download and print out these Work 'n Wheels Application Forms. These forms are in PDF format. Applicants need to complete all forms. You may download the Application Instructions. PDF File

To Apply

  1. Complete the Work n' Wheels Program Application Form 154Kb PDF File
    (Complete application includes four (4) pages)
  2. Complete the Work n' Wheels Financial Worksheet 57 Kb PDF File
  3. Read the Work n' Wheels Policy Manual 37Kb PDF File
    (Initial each section and sign on the last page)

It is important to take the time to fill out all forms completely.

If there is a question that does not apply to you or your household, write N/A (not applicable) in the space provided for the information.
(Incomplete applications may be denied and returned to the applicant)

Return completed application packets to:
Southwestern Wisconsin CAP Office
149 N. Iowa St
Dodgeville, WI 53533

Contact

If you have any questions about the Forms or Program Eligibility and Expectations, feel free to contact either Lori or Jeff at the numbers listed below:

Lori Olson-Pink
608-935-2326 extension 207
Email: l.olson-pink@swcap.org

Jeff Segebrecht
608-935-2326 extension 220
Email: j.segebrecht@swcap.org

Southwestern Wisconsin CAP Office
149 N. Iowa St
Dodgeville, WI 53533

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