Family Success Center Online Pre-Assessment
The online pre-assessment is the first step of the application process for any of the Family Success Center's Temporary Financial Assistance programs. Please complete this form and a Family Success Center representative will reach out to you as soon as possible.
First name *
Your answer
Last name *
Your answer
Phone number *
Your answer
Email address
Your answer
How many people in your household (including yourself)? *
If you are seeking assistance with back rent, your household includes all of the people with whom you currently live. If you are seeking assistance with start-up costs, your household includes anyone who will be living in your new unit.
Do you have children under 21 in your custody? *
Where are you currently staying? *
What is your housing crisis? *
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