Apply for Assistance | The Grandparents Community Network

Apply for Help

First name

Last name

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

Email

Which of the following best describes your role?

Sources of Income (including roommates)

How many children are you caring for?

Do any of the children you are caring for have special needs?

Is there anyone in the home over the age of 18?

Do you receive Supplemental Nutrition Assistance Program (SNAP) benefits?

Please explain your circumstance and need:

Please state your top two essential needs (not covered by state or federal assistance):

Please explain your circumstance and need

Please provide supporting documentation to show your need.

Examples: Lease Agreement/ Address Proof, Utility Bill, "Shut off notice" etc.