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Emergency Shelter Grant Registration

  1. This figure should be your current monthly gross income. Include unemployment benefits. Gross income for an individual is the total pay from his or her employer before taxes or other deductions. This includes income from all sources and is not limited to income received in cash. It also includes property or services received.

  2. Has your income decreased since March 2020 due to COVID-19 related issues? *

    Select One

  3. Have your expenses increased due to COVID-19 related issues? (These expenses could include child care, due to school closures.)*

    Select One

  4. Please list or indicate N/A

  5. Leave This Blank:

  6. This field is not part of the form submission.