Mother's Day 365 Housing Assistance Application

1

Please read the terms and conditions below:

All chosen applicants will be notified of their grant award via email. Please provide an email that you monitor regularly.
If notified that you are a winner, you will have 5 business days to provide The Thurman Perry Foundation with an address where you can receive funds via mailed certified check.
Please note: We cannot mail checks directly to post offices unless you have a PO Box.
If you do not provide the information within that time, you will forfeit your award.
All applicants must have either an active checking or savings account at a US financial Institution (Bank, credit union, etc.) where funds can be deposited.
If you are a previous winner of the award, you may reapply, but there is no guarantee you will be chosen again.
You will be asked to verify that you are an occupant at the address you provide. (e.g. utility bill, copy of your leasing or mortgage agreement, etc.)

2

I have read and understand the terms and conditions.* This field is required.

Yes

3

Full Name* This field is required.

First Name

Middle Name

Last Name

Suffix

4

Mobile No. :* This field is required.

Area Code

Phone Number

5

E-mail :* This field is required.Please indicate correct E-mail as your confirmation of award will be sent to this address.

Where the confirmation will be send to

6

Location:* This field is required.Applicants must be a US resident to receive housing assistance from TPF

City

State

Zip Code

Country

7

Please upload a photo of your license or other government ID:* This field is required.Scans or picture are accepted

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

8

Background Information:

This information is requested for demographic tracking and grant report generation only and in no way affects your selection for housing relief.

9

Age at time of application:* This field is required.

10

Race (Choose One or More):* This field is required.

White

Black or African-American

Asian

Indigenous American or Native Alaskan

Native Hawaiian or Other Pacific Islander

11

Gender:* This field is required.

Female

Non-Binary

12

Ethnic Origin:* This field is required.

Hispanic

Non-Hispanic

Not Indicated

13

Are you a US citizen?* This field is required.

Yes

No

14

What is your current socioeconomic range?* This field is required.

15

What is the highest level of education that you have achieved?* This field is required.

16

Are you the parent or guardian of a child under 18 years of age?* This field is required.

Yes

No

17

Are you the parent or guardian of a child over 18 years of age?

Yes

No

18

Are you currently pregnant?

Yes

No

19

Do you rent or own the home you are currently living in?* This field is required.

Rent

Own

20

How much is your monthly rent payment?

21

How much is your monthly mortgage payment?

22

Are you a beneficiary of government housing assistance?* This field is required.Receiving government housing assistance does not disqualify you from receiving housing assistance from The Thurman Perry Foundation.

Yes

No

23

Have you ever been charged with or convicted of a misdemeanor or felony?* This field is required.Arrest and/or conviction does not disqualify you from receiving housing assistance from The Thurman Perry Foundation.

Yes

No

24

Are you now or were you ever a member of the United States Armed Forces?* This field is required.

Yes

No

25

Are you now or were you ever a military spouse or dependent?* This field is required.

Yes

No

26

Do you have an active checking or savings account at a US financial institution?* This field is required.(Bank, credit union, etc.)

Yes

No

27

Have You Subscribed to Our Newsletter?* This field is required.You can subscribe on thurmanperryfoundation.org at the bottom of the page or in the pop up.

Yes

No

28

By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.

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E-Signature:* This field is required.

30

The Thurman Perry Foundation is committed to equal opportunity in housing assistance. The organization does not discriminate in any program or activity on the basis of color, religion, gender, age, national origin, disability, marital status, or any other protected class.

Please note that not all applicants will be awarded housing assistance. If you are not chosen for this cycle, you may reapply for a future cycle.