Skip to content
Skip to content
Home
About Us
Mission, Vision, Values
Staff
Board of Directors
Corporate and Community Partners
Our Impact
Job Openings
Apply for
Assistance
Client Inquiry Form
Services
Food Assistance
Clothing
Transportation
Back To School
Matthews Gives Back for the Holidays
Housing and Utility Assistance
Get Involved
Volunteer
Shop Back Porch Treasures
Donate
MHC Events
Email List – Join & View Archive
Partner With Us
Backporch
Treasures
Contact Us
Home
Services
Client Inquiry Form
Client Inquiry Form
Have you or a household member received services from Matthews HELP Center?
--None--
Yes
No
--Preferred Appt Venue--
Phone
In-Person at Matthews HELP Center
First Available
How many people reside in your household ?
--Gender--
Female
Male
Non-binary
Transgender Female
Transgender Male
Intersex
Other
Prefer not to say
Date of Birth
Do you wish to receive a text alert regarding your request? Message and data rates may apply.
--SMS Opt In--
Yes
No
--Zip Code--
28079
28104
28105
28226
28270
--Primary Need; MHC does not assist with hotel or mortgage payments--
Rent
Utilities
Rent & Utilities
Nonfinancial Assistance ONLY
Date of Eviction/Disconnection:
How much do you need assistance with?
How much can you pay?
Did your financial crisis occur within 6 months of the date you are seeking assistance?
--None--
Yes
No
Briefly describe the situation that has caused you to seek short-term emergency assistance.
What has happened out of the ordinary?
What documentation can you provide as proof of financial crisis? This will be documentation showing the cause of what has happened out of the ordinary, within the last 6 months, to put you in need of assistance. Rental and utility bills/notices cannot be used.
Financial plan moving forward:
I understand that this submission does not guarantee that Matthews HELP Center will be able to assist me with my request:
Comments are closed.
English
Arabic
Chinese (Simplified)
English
French
German
Italian
Portuguese
Russian
Spanish
Menu
Home
About Us
▼
Mission, Vision, Values
Staff
Board of Directors
Corporate and Community Partners
Our Impact
Job Openings
Apply for
Assistance
▼
Client Inquiry Form
Services
▼
Food Assistance
Clothing
Transportation
Back To School
Matthews Gives Back for the Holidays
Housing and Utility Assistance
Get Involved
▼
Volunteer
Shop Back Porch Treasures
Donate
MHC Events
Email List – Join & View Archive
Partner With Us
Backporch
Treasures
Contact Us