Welcome!

We are committed to inspiring hope, addressing social discontinuities, and empowering low- to moderate-income populations in disenfranchised and historically marginalized communities through advocacy and education.

For more information, visit www.vivifycharities.org. 

PLEASE COMPLETE THIS FORM TO REQUEST ASSISTANCE FROM VIVIFY COMMUNITY CHARITIES, AND THEN WATCH YOUR PHONE AND EMAIL FOR AN INVITATION TO FURTHER DISCUSS YOUR NEEDS OR TO RECEIVE FUNDING.

Contact Information

Attestation

I give permission to Vivify Community Charities, Inc to acquire additional information and to securely share information with other organizations for the purposes of providing services to assist my household. I am hereby making an application for assistance and recognize that any willful misrepresentation of the information on this form is subject to a penalty of law.

I recognize that Vivify Community Charities generally does not make payments directly to client applicants. Therefore, I am also authorizing Vivify Community Charities, Inc to contact my utility company, landlord, or complex for information and to make payments directly to my utility company, landlord, or complex.