HOPE HUB | CLIENT ASSISTANCE APPLICATION
Hope Hub Inc. serves Fulton, Clayton and DeKalb counties in Georgia. Use this application to request assistance. Staff review each request individually; applying does not guarantee eligibility, assistance, placement, funding or a response by a particular time.
All new requests initially enter Waitlisted status until staff begin reviewing them. Waitlisted does not mean approved or declined. Applications may be submitted at any time. Reviews take place Monday through Friday; no weekend reviews are scheduled.
Housing assistance funds are currently exhausted. We continue accepting and processing housing requests; funding approval and payment remain on hold while funds are unavailable.
Provide only the information requested. This form is not monitored around the clock and is not an emergency service. For immediate danger, call 911. For local community resources, consider 211.
Contact and Household Details
Full Name
*
First Name
Last Name
Preferred Contact Method
*
Email
Phone
Email Address (required if Email is selected)
example@example.com
Phone Number (required if Phone is selected)
Please enter a valid phone number.
Format: (000) 000-0000.
Number of People in Household
*
Assistance Request
County
*
Please Select
Fulton
Clayton
DeKalb
Other
If you selected Other, please specify your county
*
Which assistance program are you requesting? Select exactly one.
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Housing
Utilities
Food
Transportation
Other
Program-specific details (show only the questions applicable to your selected program)
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Do you know the amount you are requesting?
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Yes
Not yet
Requested dollar amount (digits format as cents: 12550 = $125.50)
*
Check your requested amount
*
I checked the displayed dollars and cents, and this is the amount I intend to request.
Amount requested ($)
Enter zero or a positive dollar amount, using at most two decimal places.
Amount requested (enter an amount or “Unknown”)
Enter a non-negative dollar amount with up to two decimal places, or Unknown.
Describe the hardship and assistance needed. Do not include sensitive personal information.
*
Deadline for assistance, if applicable
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Housing eviction information
These questions help Hope Hub staff review urgency. Select Not sure if you do not know. Completing this section does not guarantee assistance.
Are you currently facing eviction?
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Yes
No
Not sure
Has an eviction case been filed in court?
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Yes
No
Not sure
Do you have a confirmed court date for the eviction case?
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Yes
No
Not sure
What is the confirmed court date?
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Has a court already entered a judgment in the eviction case?
*
Yes
No
Not sure
How did you hear about Hope Hub?
Please Select
Family or friend
Community organization
Social worker or case manager
Online search
Social media
Other
Have you received assistance from Hope Hub before?
*
Yes
No
If yes, briefly describe the assistance received
*
Best time to contact you
Please Select
Morning
Afternoon
Evening
Any time
Housing assistance funds are currently exhausted. We continue accepting and processing housing requests; funding approval and payment remain on hold while funds are unavailable. Submitting an application or completing review does not guarantee assistance.
Why we ask Hope Hub Inc. uses your contact details, household size, county, assistance history and request information to review your request, contact you and coordinate authorized services or referrals. Housing eviction filing, confirmed court-date and judgment answers help staff review urgency. Staff review each request; these answers do not automatically determine eligibility. Applying does not guarantee assistance or funding. Review schedule and initial status Applications may be submitted at any time. Hope Hub reviews new requests Monday through Friday; no weekend reviews are scheduled. Applications continue collecting during staff absences and wait for review when the reviewer returns. Review may be delayed during absences. Submitting a request does not guarantee a response by a particular time or assistance. All new requests initially enter Waitlisted status until staff begin reviewing them. Waitlisted does not mean approved or declined. Housing funding Housing funds are currently exhausted. We continue accepting and processing housing requests; funding approval and payment remain on hold while funds are unavailable. Completing review does not guarantee assistance. Provide only what is needed Do not enter passwords, sign-in codes, Social Security numbers, dates of birth, bank or payment-card details, medical records or identity documents. Do not upload documents here. If a specific document is needed, Hope Hub will separately arrange a secure request. This form is not monitored around the clock and is not an emergency service. Where information goes Jotform holds the original application, including your name, contact details, application narrative and eviction answers. Hope Hub uses OpenAI Sites for its private case dashboard, which stores a case ID, program, requested amount and internal coordination records. The intake service processes application answers to select the fields it saves; names, contact details, application narrative and eviction answers are not copied into dashboard storage. Case IDs remain linked to the original application. Google Drive holds encrypted backups of original applications and dashboard records for recovery after a technical problem. Access is restricted to authorized Hope Hub personnel and necessary service providers. Authorized personnel and service providers process information as needed to operate these services. Optional referral sharing requires appropriate separate permission. Applying is not permission for marketing or public testimony. Retention Under Hope Hub's adopted schedule, applications closed without assistance are generally retained for twelve months after final closure and completion of any appeal or reopening process. Necessary assistance-decision and financial-support records are generally retained for at least seven years from the end of the fiscal year containing the latest relevant closure, final payment or reporting event. Holds, funding conditions and other applicable requirements may require longer retention. Backup copies and unresolved matters may remain after a deletion request. These are Hope Hub's policy periods, not a promise of automatic deletion. Questions and requests Contact hope@hopehubatlanta.org for questions, corrections or requests to review access to or deletion of your information. Hope Hub may verify your identity and consider retention requirements before responding. Do not email passwords, identity documents or unrelated sensitive information. Hope Hub Privacy Policy: https://www.hopehubatlanta.org/privacy-policy Jotform also describes its technical-data practices in its privacy policy: https://www.jotform.com/privacy/
Consent and Acknowledgement
Consent to Be Contacted
*
I consent to be contacted about my assistance request
Screening and Eligibility Acknowledgement
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I understand requests are screened and that eligibility and assistance availability are not guaranteed
Submit Request
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