Financial Assistance Screening
READ BEFORE YOU FILL OUT THIS FORM

We DO NOT guarantee that you will receive assistance. We have a limited amount of funding, so we are unable to assist every request. We will only contact you if you meet the qualifications and can provide PROOF.
We will be contacting your landlord, utility company, or mortgage company for verification of debt and history of payments. We will verify the database system for assistance received. Catholic Charities will only pay for a certain percent of your rent/mortgage or utility, if you qualify for assistance.
Qualifications consist of:
---Must be 18 years or older
--Meet the income guidelines
---Not be on Section 8
---Be a CURRENT client with a Financial Coach or Catholic Charities Dallas programs
---Meet with a coach at least 3 times for goal updates
---Have not received assistance within the last 6 months from any other organization

Please DO NOT contact Catholic Charities for updates on your application. We receive all information via this form and have all of your information to contact you, if you qualify. Failure to comply will result in your application being eliminated from the process.
How did you hear about our Financial Assistance? *
What is your name? *
Your answer
What is your phone number? *
Your answer
What is your email?
Your answer
What is your zip code? *
Your answer
What County do you live in? (We are unable to assist Denton or Tarrant counties) *
Are you on Section 8 assistance? *
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