If you are a resident of St. Joseph county only and in need of rental or utility assistance, please fill out each section of this form. These questions will help determine if your family may qualify for one of our financial assistance programs.

This program is for people who have NOT had a COVID-19 related job loss. 

If you have had a COVID-19 related job loss, please click here to apply to the ERA program:  www.sjcindiana.com/era

We cannot process your request without all of this important information, so please answer every question included on the application form. Please be prepared to provide proof of household income, identification, and copies of lease agreements/ bills/invoices.

We will be in contact via email or phone regarding your application.

PROGRAM CHOICE 

If you are on a fixed income and/or did not lose your job or have an income reduction due to COVID, select Non-COVID related rental and utility assistance.

If you are applying for Team Heat matching energy assistance funds only, select Team Heat.

Do not submit this form more than once.

Terms & Conditions:
If you qualify for financial assistance from the St. Vincent de Paul Society  it is your responsibility to do the following before any financial distributions have been made:

1. Before your scheduled appointment, provide SVDP all required documents including copies of:

• Photo ID
• Proof of Address
• Proof of Income (pay stubs, bank statement, SSI/TANF statement)
• Bills to be paid, including amount due, account number, and address where we send payment
  
  PLEASE UPLOAD YOUR DOCUMENTS BELOW IF YOU ARE ABLE.
  
  If you are not able to upload documents to this application, please check your email after submitting this form with instructions about how to get the documents to us.

2. Meet via phone or video conference with a SVDP team member or volunteer to discuss your case.  

UPLOAD DOCUMENTS HERE

I understand that the St. Vincent de Paul Society of St. Joseph County, Inc. (SVDP), may need to obtain and/or share information about me to establish my eligibility for services such as client choice pantry, home food delivery, food and clothing vouchers, rent and utility assistance, and any other SVDP program for which I apply.  I also understand that SVDP may obtain and/or share information about me through written, oral, and electronic communication.

By signing my name below:

• I authorize SVDP to obtain information about me from other agencies, organizations, and individuals for the limited purpose of making decisions about my eligibility for and participation in one or more SVDP programs.
  
  
• I authorize SVDP to share information about me from other agencies, organizations, and individuals for the limited purpose of making decisions about my eligibility for and participation in one or more SVDP programs.
  
  
• I understand that my authorization will remain effective from the date I sign below until I withdraw this authorization in writing.
  
  
• I understand that I may withdraw this authorization at any time by delivering a written notice to the Executive Director of SVDP, and that my withdrawal will be effective when SVDP receives it.
  
  
• I understand that SVDP will handle my personal information in compliance with all applicable laws.

By submitting this form, I acknowledge these terms of service.