Hope Seed Support Center Hope Voucher

Thank you for coming to Hope Seed Support Center. It is an honor to be able to help you during this difficult time in your life. As a part of our mission, Hope Seed Support Center (“Hope Seed”) provides financial assistance to individuals who lack the ability to pay for mental health counseling. We  want to make this process as quick and easy as possible, however, we will have to verify your financial needs.  

Our Hope Voucher Program for financial assistance takes many factors into account including proof of employment, income level, family size, other assets, and income resources. Each Hope Voucher provides one counseling session with the option for more as evaluated by your counselor.
Please fill out a Hope Seed Voucher Application below and submit it with one of the six verifications for financial assistance. Our organization offers sliding scale counseling fees based on income or financial need.

1.      Copy of your most recent Tax Return

2.      Copy of Social Security Benefits or Disability Check (if receiving)

3.      Copy of two of your most recent paystubs for each person working within your home.

4.      Copy of recent Welfare Benefits, TANIF, Food Stamps, Section 8 Housing Letter (if applicable)

5.      Copy of Unemployment Benefits Statement or Paycheck Protection Program (if applicable)

6.      If No Income verification: please have a letter notarized from the person(s) who provides your monthly living expenses or rent.

If you do not have your tax return, please contact the IRS for a copy. If you did not file taxes this year and can not verify any other documents on this list, please submit a letter to Hope Seed Support Center explaining your personal situation by email or mail:

Email: hopeseedhouston@gmail.com

Hope Seed Support Center

Attn: Hope Voucher Program

13131 Champions Drive Suite 208 Houston, TX 77069

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Name *
Address *
Phone Number *
Email Address *
Sex *
Status *
Employment *
Employer/Address/Phone

Have you ever applied for a Hope Voucher before? 

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Are you receiving any other financial assistance?

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What type of Financial Assistance do you receiving?
Partner's Name (if you live together)
Partner's Employer

Dependents who live in the household: (under age of 18 years old)

What counseling needs can Hope Seed Support Center help you or your family with?
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Please check that apply:


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Required
Have you ever attempted suicide before? 
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I hereby clarify that the information provided above is true to my belief and knowledge.

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Required
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