needs assessment unit application form




1-3 Persons
in Household
4-6 Persons
in Household
7+ Persons
in Household
Income Maximum Threshold $3,000 $3,500 $4,000







  • Rent
  • Rental Deposit
  • Food
  • Utilities
  • Clothing
  • Propane
  • Telephone
  • Transportation
  • Internet
  • Burial Assistance
  • Pre-School
  • After-School Care
  • Summer Camp
  • School Uniform
  • School Shoes and Supplies
  • Medical Travel
  • Medical Equipment and Supplies
  • Optical
  • Dental
  • Long Term Financial Assistance (LTFA)
  • Pines Placement
  • Indigent Insurance Coverage**
  • Housing Repairs Assistance**

  • Unemployment
  • Inadequate Income
  • Health issues
  • Disaster
  • Domestic Violence