WRAP - Wisconsin Rental Assistance Program PRE-SCREEN Application
In collaboration with the Department of Administration through the CARES Act, Lakeshore CAP is assisting households who are struggling paying their rent due to an income loss because of COVID-19.

In general, applicants need to be a Wisconsin resident with a household income at or below 80% of the county median income (CMI) in the month prior to the application date. Households at or below 60% CMI will be prioritized for assistance.

The following situations will not qualify for this program: those receiving a Section 8 voucher or assistance through a Public Housing Authority and mortgage payments.

Along with the rental assistance application, you will simultaneously be applying for Energy Assistance. If you have applied for Energy Assistance in 2020, much of your information is within the system that generates assistance for rent. You will not be eligible for an additional Energy Assistance payment.

Assistance will be paid directly to your landlord once all information is verified.

You must reside in Door, Kewaunee, Manitowoc, or Sheboygan Counties in order to receive assistance through Lakeshore CAP. If you reside in a county other than those listed, please click on the link below to locate your service provider: https://doa.wi.gov/Secretary/WRAP-CAPContacts.pdf

If you need help filling out this application, please call 920.682.3737.

documents @ lakeshorecap.org (with no spaces)
Email address *
Before continuing, please check to see if you are below the maximum monthly income limit for your county and household size -- for the month prior to your application.
First Name *
Last Name *
Street Address *
City *
Zip Code *
County *
Primary Phone Number *
How many total people live in your household? *
List the names of household members: *
Has your household experienced a loss of income due to COVID? (Although income loss due to COVID is required for WRAP funding, we have other funding available for non-COVID reasons so please continue.) *
What is your household total monthly gross income? Income includes employment wages, unemployment, social security, retirement, child support, etc. Household income will need to be verified. *
Have you had income in the past 30 days? *
Do you have a valid lease with your landlord? *
Have you received an eviction notice from your landlord due to non-payment of rent? A copy of the notice may be required. *
What is your monthly rent? *
Are you currently behind on rent? If yes, how much do you owe? (If up to date on your rent, put 0.) *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Lakeshore CAP, Inc.. Report Abuse