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Employee Assistance Program

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Emergency Loan Fund (ELF) - Monthly Budget

Please print this page and bring completed form to EAP.

Monthly Budget


$__________ Rent/Mortgage

$__________Car Payment

$__________Gas, Car Repairs


$__________Telephone (Cell and Regular)


$__________Child Care








$__________Medical/Dental/Counseling Expenses



$__________Credit Card Payment

$__________Misc (haircuts, dining out, newspaper, etc.)

$__________Loans, specify: _____________________________________


$__________Total Expenses


$__________Monthly Net Income

Back to Emergency Loan Fund (ELF)


Contact Information

Employee Assistance Program
126 College Avenue
Orono, Maine 04473-1580
Phone: 207.581.4014 or 1.877.EAP.3315 | Fax: 207.581.3017
The University of Maine
Orono, Maine 04469
A Member of the University of Maine System