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Thank you for visiting our Rental Assistance registration page.
You will receive an email within 24 hours acknowledging receipt of your application.

If you meet basic criteria required by our funders, we will contact you via email with your application status and next steps within 5 business days.

Please be understanding if there is a slight delay as we are receiving a large number of requests. We will respond to you as quickly as we can and there is no need to submit your information again.

Due to funding restrictions, not all households are eligible for rental assistance. 

Please complete the information below.
All fields below are required.

v3.2


Rental Assistance Application
Please type your first name
Please enter your last name
Enter your Email address
Enter your Area Code and Phone Number as ###-###-####
Enter your Street Address
Enter your City
Enter your ZIP Code

Please do not leave any of the following fields blank. 

If the field does not apply to you,
please enter 0 (zero) if a number is required

Enter the number of Adults (18 years and older) in your household
Enter the number of seniors (age 62+) in your household
Enter the number of Children (less than 18 years old)
Disabled
Is a member of your household disabled?
Homeless
Has your household been homeless in the past 3 years?

ALL questions must be answered.

Enter your pre-COVID household monthly income
Enter your current household monthly income
Please choose the reason for your change in income
Job_Documentation
Do you have documentation for your job situation?
Job Documentation
Enter your current monthly rent amount
Monthly Rent
How many months of rental assistance do you need?
Utilities_Owed
Are you behind on paying utilities?
How much do you owe in past-due utilities?
Your_Utilities
Please check the boxes for your past-due utilities
Your Utilities
Phone_Times
What are the best times to call you Monday-Friday - check all that apply


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