St. Vincent de Paul Appleton

St. Vincent de Paul Appleton

Assistance Request
St. Vincent de Paul in Appleton currently has limited funds for rent and utilities. There may be other ways that we can support you. You are welcome to continue your request, which will be passed on to a home visit volunteer team.

For assistance in Neenah & Menasha:

Contact Neenah SVdP www.svdpneenah.org/helpline.

For assistance in Kaukauna, Little Chute & Kimberly:

Contact Kaukauna SVdP (920) 766-9221

Assistance Request Process

1. Submit request

2. A SVdP volunteer will call to discuss request.

3. After the call, a meeting may be set up to visit in person.

4. Notification via text/email will be sent IF a voucher is activated.

Please Note:

· Vouchers cannot be activated by store staff.

· Home visit volunteers do not work at the store office.

· A call or visit is required before a voucher is activated.

· Accurate phone numbers and/or emails ensure timely visits.

· Requests must be submitted online.
Today's Date*

MonthDayYear
Date
Your name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email:
example@example.com
Date of Birth*

MonthDayYear
Date
Household Members
Name, Date of Birth, and Relationship
Assistance Request
What kind of assistance do you need? Please be specific:*
If rental assistance, please include landlord name and phone number.
*Please know that by submitting this form you agree and acknowledge that St. Vincent de Paul (SVdP) Appleton may send text messages to your wireless phone number in regards to SVdP program assistance. You acknowledge that you are responsible for any rates that may be associated with texts on your wireless account. You acknowledge that this consent may be removed at your request by contacting the SVDP Appleton office, but that until such consent is revoked, you may receive text messages from SVdP Appleton at your wireless number.*

Yes, text me!No, do not text me!
Should be Empty:

St. Vincent de Paul Appleton

Assistance Request