ST. VINCENT COMMUNITY HELPING HANDS INC

Rent and Utility Bill Assistance

If youre struggling to pay your bills or keep food on the table, we may be able to help.
St. Vincent community helping hand provides financial assistance to those in need. We offer rental and utility assistance programs to those who are struggling to get back on their feet. We know that times are tough and money is tight. That's why we're here to be of help.

Full Name*

Phone Number*

Email Address*

Date of Birth*

Gender

Male

Female

Marital Status*

Occupation*
If you're unemployed please fill in "not employed"

Monthly Income*
If you're unemployed or have no income please fill in $0

What do you need help with?

Rental Assistance

Utility Assistance

Do you have a verifiable past due rent notice or due utility bill?

Yes

How much is your owed rent or due utility bill? *
Amount approval and disbursement is subject to available funds

Home Address*

State*

City*

Zip*

Verification
We're very determined to be of help so it is important for us to know our help is getting to real people who needs the help, our approval is dependent on our ability to verify that you're who you say you're and verifying your need for assistance.

Social Security #*

I authorize this form to collect and capture my sensitive information like SSN and driver's license. I agree for St Vincent community helping hand to do a background check on me in relation to my assistance application.