EMERGENCY CASH ASSISTANCE COVID-19
Detroit LIVE-FREE COALITION will be assisting 150 families that reside in Detroit, Highland Park and/or Hamtramck who have been financially compromised due to the COVID-19 pandemic with a one-time deposit of $500.00. You must have a bank account. Please fill out the form to qualify for cash assistance. Information will only be used for the purpose of qualifying candidates for cash assistance. Please be advised that filling out this form does not guarantee you will qualify for cash assistance. You will be notified via email within one week whether you qualify or not.
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Phone Number *
Home address include City/State *
Zip-code *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Detroit Peoples Community. Report Abuse