LLRC Financial Assistance Request

We are so grateful to be able to assist you in any way and thank you for contacting us for support.

-Please note that LLRC is a noprofit organization and cannot guarantee assistance. Our goal is to meet the needs of you and your family and restore you to wholeness but due to funding that may not be possible.

-We do not provide immediate assistance and it may take 3-5 business days before a decision is met.

-If approved, you may not apply for assistance again within a years time frame of your approval.

-Please upload a valid photo ID (as proof of identity) and any bills associated with your request. Failure to do so will result in a denial for assistance.

-LLRC does not give funds direrectly to people. We pay organizations, companies/businesses directly.

Signing below signifies you have read these terms and ackowledge acceptance of said terms.

LLRC exists to assist and support single mom's. Are you a single mom?

Do you live with a significant other?

Do you live in one of the following counties (please select)?

Name

First NameLast Name

E-mail

example@example.com

Phone Number

Area CodePhone Number

Amount Requesting

Family Size (how many in your family, currently living with you)

What are you requesting assistance with?

Please upload Photo ID and the bill(s) you are requesting assistance with.

Currently Employed?

If employed, where?

Do you have any other additional income? (child support, disability, etc.) If yes please lists the additional income to include the amount.

Have you ever taken a budgeting workshop or program?

We offer a free program called Thriving via Stewardship. It's a Faith & Finance workshop that's not just about budgeting but also managing your finances with God. We share several tips, scripture and a budgeting worksheet to help you get started.

Please visit the link below for your FREE access.

https://www.llrcinc.org/programs

Signature: By signing below you are attesting that the information shared in this application is true & accurate.