RISE Relief & Recovery Progam Application


Detroit Phoenix Center is assisting children, youth and families that reside in Detroit who have been financially compromised due to the COVID-19 pandemic with assistance with the following: Food & Income Support, Rent & Hotel Vouchers, Cell Phone Bill Support, Tablets & Transportation Assistance.

We are a nonprofit high impact nonprofit organization that provides critical resources, wrap around support and a safe, nurturing community to underserved & transient youth, children and families.

The information provided in this form is confidential and will be used to qualify candidates for the RISE Relief & Recovery Program.

Program funded in part by:
McGregor Fund
United Way of Southeastern Michigan
Jacob Family Foundation

For More Information: www.detroitphoenixcenter.org/COVIDsupport or Leave a message at (313) 482-0916

Please note that funding is limited so not all requests will be filled.

Email address *
First name *
Date of Application *
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Last name *
Current Address (or place of residence) *
Phone Number *
Secondary phone number where we can leave a message for you: *
What is your zip code? *
Gender *
Birthdate *
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Email address: *
How many people in your household? *
Are you eligible for free/reduced lunches or Medicaid? *
Are you or anyone in your immediate household experiencing any of the following living situations? Living doubled up, couch surfing, living in a car, shelter, motel, shelter or any other transient situation? If yes, for how long? *
Have you received assistance from another organization? *
Have you received asistance from the Detroit Phoenix Center in the past? *
Why are you requesting support from Detroit Phoenix Center now? (Please describe your situation) *
If DPC is not able to fulfill your request, how will you get your needs met? *
Is anyone in your household a student in the Detroit Public Schools Community District? *
What are your top 3 needs: *
Required
If you have any dependents what is their name, age, month and year of birth?
Do you have access to: *
Required
Is your household situation related to Covid-19? *
Does someone in your household have a disability? *
Is someone in your household pregnant? *
Can you provide proof of ID? *
If asked, are you able to provide any proof of past due rent or utilities? (bill, leasing, agreement) *
If you receive assistance from our program the main result(s) will be: *
Required
Would you like to continue to receive support from the Detroit Phoenix Center post Covid-19? *
Is there anything else you need to share with us about your application? *
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