Application For Assistance

Date Of Application

Date

Full Name*

First NameLast Name

Email Address

example@example.com

Contact Number*

Please enter a valid phone number. This is how you will be contacted regarding this request.

Date Of Birth*

Date

Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Total Number Of People In Household Including Yourself*

Please list full names and ages of everyone in your household.*

Current Living Situation:*

Relationship Status*

Select The Type Of Assistance You Are Requesting (One Per Application)*

Please Upload A Copy of Your Valid ID*

Please describe your current financial situation and why you need assistance.*

Are You Currently Employed?*

YesNo

If Employed, Please Upload Income Documents

If Married, Is Your Spouse Currently Employed?*

YesNo

If Spouse is Employed, Please Upload Income Documents

Total Monthly Household Income*

Total Monthly Household Expenses*

Do you/your child(ren) receive any assistance from the state? (EXAMPLES: SNAP, Medicaid, Disability)*

YesNo

Please list all government assistance you receive.

Please Upload Proof Of Expenses (If You Live With Someone And Bills Are Not In Your Name, Please Have the Head Of Household Submit A Signed Letter Stating Your Living Arrangement)

Please list exactly what you and/or your child(ren) need, being as specific as possible. For food assistance, you may include any dietary restrictions or preferences; however, specific food items cannot be guaranteed, as we provide what is available at the time of your request. Please note that assistance for food and/or Holiday meals will not be based on individual requests. For back-to-school needs, please list each child’s clothing and shoe sizes as well as any specific school supplies required. If you would like to list the child's school and grade level, we can search for their supply list online. For Christmas assistance, please share each child’s wish list, including interests, favorite characters, or particular items they would enjoy.*

PLEASE READ BEFORE SUBMITTING REQUEST: Terms & Conditions

It Takes A Village: SMP – Assistance Program Guidelines

Organization Purpose:
It Takes A Village: SMP is a 501(c)(3) nonprofit organization dedicated to providing essential resources to individuals and families in need throughout our community on an as-needed, short-term basis. Our support is made possible solely through community donations. We do not receive or qualify for any state-funded grants or loans.

Scope of Assistance:
We assist with short-term financial crises only. We do not provide ongoing financial aid or long-term support. Families requiring extended assistance will be referred to other trusted community resources within St. Mary Parish.

Limitation Policy: Applicants are eligible for assistance once every 90 days, unless otherwise approved by the Board under special circumstances.

Application Process:

Submit a complete application.
Provide required documentation, including:
- A copy of a valid ID
- Proof of income
- Proof of expenses
  - If living with someone and not listed on bills, submit a signed statement from the individual responsible for household bills.
Application will be reviewed and approved/denied based on current available funds.
If approved, a team member will contact you to confirm exactly what is needed.
Items will be purchased and pickup/delivery will be scheduled.
1. Food requests: 1–3 day turnaround
2. Thanksgiving meals: Delivered the week of Thanksgiving
3. Christmas gifts: Delivered at least one week before Christmas
4. Other requests: Timing based on availability of funds and volunteers

Appeal Policy: Applicants who are denied assistance may submit a written request for reconsideration within 7 days. Reapplication is allowed after 90 days, unless otherwise stated.

Communication Policy: All communication regarding your application will be sent via phone, text, or email. It is your responsibility to ensure that your contact information is up to date and that you respond in a timely manner.

No-Show, No-Service Policy: If an applicant fails to show up to receive scheduled items or does not make arrangements in advance (minimum 2 hours prior), they will no longer be eligible for assistance from It Takes A Village: SMP. We rely on volunteers and donated resources, and missed pickups result in waste and prevent others from being helped.

Third Party Pickup/Delivery: If an applicant sends someone else to pick up items on their behalf, that person must be pre-approved and may be required to show ID. It Takes A Village: SMP is not responsible for any items lost, stolen, or misused once they are released to the designated third party.

Important Notes:

Funds are not given directly to applicants. No cash, checks, or monetary forms of aid will be provided.
The preferred method of assistance is purchasing items on behalf of the applicant and delivering them directly.
All decisions are based on current needs, available resources, and the discretion of the organization.

Eligibility Requirements:

Must be experiencing a short-term financial crisis
Must be located in St. Mary Parish

Assistance Exclusions:

Long-term financial hardship
Repetitive or ongoing expenses
Applicants who have previously misused program funds

Misuse of Funds Policy:
Any individual found misusing or abusing program assistance will be permanently banned from receiving future aid and may be required to repay any funds or items received. Misuse includes, but is not limited to:

Providing false or misleading information on the application
Returning donated items for cash
Selling or giving away donated items
Returning Christmas gifts to the store

Volunteer Safety Policy: For safety, volunteers are not permitted to enter an applicant’s home under any circumstances. All deliveries will be left at the door or handed off outside the residence.

Non-Discrimination Statement: It Takes A Village: SMP does not discriminate based on race, color, sex, national origin, age, or disability.

Privacy Statement: All information submitted to It Takes A Village: SMP will remain confidential and will only be used to determine eligibility for assistance. I give my permission for It Takes A Village: SMP to share limited personal information (such as name, contact information, and basic assistance needs) with partnering organizations, community agencies, or volunteers for the sole purpose of coordinating services, preventing duplication of assistance, or securing additional support on my behalf. I understand that It Takes A Village: SMP will never sell or misuse my information, and will only disclose what is necessary to provide services effectively.

It Takes A Village: SMP reserves the right to update, change, or discontinue these guidelines at any time without notice. Any changes will apply to all current and future applicants.

By Electronically Signing Your Name You Agree To All Terms & Conditions*

First NameLast Name

Signature*