Emergency Financial Assistance Intake Form

To relieve the burden on our phone system we have added an online option to request assistance. Please fill out the form below to start the process. Submission of this form DOES NOT guarantee that you will be granted an appointment or assistance.

Please know that we are dedicated to helping as much as we can, however you may not qualify for certain types of assistance.

I need help paying my utility bills

If you need help paying your utility bills please fill out the form below.

We're sorry, we have no more availability for online utility application requests at this time.
Please know that your request submission was successful when you receive an email confirmation after, and to check your inbox to complete the full application form. More applications will be available on Monday October 2nd.

I need help paying my rent or mortgage.

If you need help paying your rent or mortgage please fill out the form below.

We're sorry, we have no more availability for online past due rental application requests at this time. Please know that your request submission was successful when you receive an email confirmation after, and to check your inbox to complete the full application form. More applications will be available on Monday October 2nd.

I need other types of help.

If you need help other than utilities or rental assistance, please fill out the form below.