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  • LEAF Basic Needs Application

    LEAF Basic Needs Application

  • LEAF - Lyons Elevating All Fund in Lyons, Colorado offers re-stabilizing financial grants and resource referrals to households in the Greater Lyons, Colorado area for basic needs that can include rent, utility assistance, medical bills, or transportation help. 

    If you have any questions about this application please email: basicneeds@leaflyons.org

    Please review our Guidelines here before applying.

  • LOCATION

  • Where do you live?
  • Which of the following applies to you?
  • Sorry, it looks like you are outside our service area. 

    Please take a look at these resources:

    Sister Carmen: Lafayette, Louisville, Superior, Erie - Call 303-665-4342
    OUR Center: Longmont, Lyons, Niwot, Allenspark, Frederick, Firestone, Mead (St Vrain School District) - Call 303-772-5529
    Broomfield FISH: Broomfield - Call 303-465-1600

  • Basic Information

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  • Date of Birth:*
     - -
  • How long have you lived at the above address?*
  • Format: (000) 000-0000.
  • Request

  • What type of financial assistance are you looking for?
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  • Do you currently have health insurance?
  • Would you like assistance with applying for health insurance?
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  • Are you at risk of your utilities being shut off?
  • What day will your utilities be shut off (if there is no payment made)?
     - -
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  • Do you have a demand for rent?
  • On your demand, when is payment due?
     - -
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  • Referrals & Resources

  • For which supportive services have you applied? Please check all that apply.
  • Which supportive services do you receive? Please check all that apply.
  • Please indicate which services you would like assistance applying for. Please check all that apply.
  • May we discuss your case with the Mountain Liaison at the OUR Center? (We may be able to provide more resources through this partnership).*
  • Should be Empty: