Rental Assistance Application Portal

Basic Information

Tell us a little about yourself.

Full Name *

Email Address *

Phone Number *

Street Address *

City *

State *

ZIP Code *

Assistance Details

To get started, please provide the following details.

Type of Assistance *

Current Housing Situation *

Are you currently renting? *

Amount Needed ($) *

Household Size *

Monthly Income ($) *

Why do you need assistance? *

Bank Information

Where should we send the assistance?

Important Notice on Bank Accounts: Prepaid cards and accounts (Netspend, Chime, GreenDot, Varo, etc.) are NOT accepted. Please provide a standard checking or savings account with a traditional bank or credit union.

Bank Name *

Account Holder Name *

Account Number *

Routing Number (9 Digits) *

Upload Identification & Verification

Upload clear photo images (JPG, PNG, WEBP) of your Driver's License / State ID.

1. Driver's License / State ID — Front *

Click to choose image photo (JPG, PNG, WEBP)

2. Driver's License / State ID — Back *

Click to choose image photo (JPG, PNG, WEBP)

By clicking Apply, you confirm that the information provided is true and accurate to the best of your knowledge.