Terms for Submitting the Application

Privacy:

I agree that all information I provide in this application will be shared with nonprofit partners who provide assistance.  The personal contact information will only be used to process this request.

I realize that this applicaiton will be canceled if I do not respond to the provided assigned agency and provide the required information within 10 days of submitting the request.

If I choose to provide personal information in the comments or attached documentation, I will not include detail medical or mental health information.

Timely Support by Email (added 6/19/2024)

If I have an email account, I will add the following contacts to my email list: help@theconnectorwga.org, no-reply@theconnectorwga.org, and provided agency emails. I realize that a response will be sent to my email, if provided, within 1 hour to 48 hours of hitting the submission. If I don't get a response, I will check my spam or junk folder.  I realize that failure to respond to an email from The Connector could result in delayed or canceled requests.  I understand that failure to send requested documents directly to the agency's email (not help@theconnectorwga.org), could result in denial of services requested.

How to Cancel the Request:

At any time, I can cancel the service request by sending an email to cancel@theconnectorwga.org or contacting the assigned agency for my request(s).

This application is only for people living in the counties: Carroll, Haralson, and Heard.  The resources for residents of Villa Rica in Paulding and Douglass Counties are limited are not available through The Connector.

Locate Your County

If you do not know your county, go to this website:  click here, scroll to the list of counties and cities.  In the search area, type the city to determine your county.  Alternate Site: USPS

Need Help But Live in Another County

If you do not live in Carroll, Haralson, or Heard, go to this Georgia Resource site: click here or https://theconnectorwga.org/resources.

Request for Services

The request for services are divided into financial aid for rent, mortgage, lease, utilities, transporation, etc and services.  Requests for financial aid requires more documentation.  The avereage amount provided for finanical aid is under $600.  For large requests, this requires you to request client support for collaboration with multiple agencies, children's schools, your work place, friends, family, etc. 

Holidays: The agencies will be closed for Christmas, and New Years.  

Other services:

Client Support: Provides guidance on getting support and collaborating resources across agencies

Financial Aid Transportation includes car maintenance, car payment, car insurance, etc. (excludes gas)

Transit Services: Includes transportation to and from appointments 

Pick Up and Drop Off is for the Carroll Co Transit System which is $3 each way

Rents Vs Hotel Stay:  If you are staying in a hotel, use the "Hotel Stay" request.  If you are in an apartment or house and renting, then select "Rent" request.  This ensures that your request is matched with a the correct agency to provide the support and not cause a delay or denial of request.

Homeless: select Hotel Stay for service (initial contact is through email) 

Medical Expenses: Includes prescription, appointments, etc.

Mental Health Services: If you are having suicidal thoughts please dial 988.
Help is available. You are not alone.

Services for Villa Rica addresses in Pauling and Douglas County are no longer accepted.  Services for Haralson County are referred to Haralson Family Connection at 770-328-1736 and https://haralson.gafcp.org/.

To Request a Service or Financial Aid:

Below, select the one or more services in the order of need. The amount refers to financial or number of services such as nights. The agencies may take up to 10 days to complete this request. For immediate assistance, go to https://theconnectorwga.org/resources.

Referral of Services

The following services are not available by a provider agency within The Connector.  You will be referred to an external agency that you may contact.

• Birth Certificate
• Child Care
• Death Certificate
• Eviction Support
• Financial Aid for transportation
• Government Phone and Internet Access
• Home Repair Assistance
• Legal Assistance
• Marriage Certificate
• Medical Services
• Mental Health Services
• Other Financial Aid
• Social Security Card
• State and Federal Support
• Transit Services
• Yard Assistance

The above services are located at https://www.theconnectorwga.org/resources.

You can request more than one service.

Communication Language

Most of the agencies do not have language interpreters.  In the "Additonal Notes" section, include the communication language that you will need if not English.  With the use of online translators, such as Google Translate, email, and text messaging, we can be provide basic initial communication.  For example, see Google Translate.

Questions:

Answer each of the following questions as yes or no, especially for financial aid.  If you are not requesting financial aid, you may choose select "Does Not Apply."  By accurately answering the questions, you increase the opportunity to be connected with an agency that can provide assistance. 

Each request is reviewed by an agency.  Services may be denied due to unavailable resources, not meeting agency criteria for assistance, out of geographic area, recently provided assistance, etc.

First, provide name, gender, and birthday for yourself, as the applicant, separately from the other household members, if any.

Please enter each person in your household, including Name: First, Middle and Last, Date of Birth, Gender, and Relationship to you.  To include someone who may become part of the household during the request time frame, use the relationship "Unborn child" or "Future Member" (Optional).

Remember:  DO NOT include yourself with the household information since you provided the information above.

In order to complete the request, the you must provide a valid email OR phone number.

Responsiveness to Agencies

The assigned agency for each request will contact you within 10 days of submitting this request.  If you do not respond to the agencies request after three times within 5 days, then your application may be canceled.

The request is automatically canceled if there is no valid method of contact by email or phone number.

The fastest means of communication with The Connector is by email.

A valid email is highly recommended to get timely responses from the agencies and request updates. A copy of this application will be sent to this email address with instructions for the next steps. Enter the email twice to ensure the information is correct. (see Free Emails)

To see if you qualify for a free government phone, go Free Phones.  Another option is to get a Free Telephone Number.  If you have a "Free Telephone Number", enter the type of service used at the end of the form under "Additional Information". (Please get one that does not require the agency to know the "app" for communication). 

Email and Validation

If you do not have an email, type noemail@theconnectorwga.org.  Not having an email may cause delays in the response.  Consider setting up an email using "Free Emails" above.  If you do not receive an email with the agency who is providing your requested service or an email with external resources within 24 hours, send an email to help@theconnectorwga.org.

Address Validation

The city and zipcode is required to validate that you live within the service area for The Connector.  If you need to validate your location, you can go to the website: USPS (https://tools.usps.com/zip-code-lookup.htm?byaddress).  If you are homeless, then select a location where you spend the most time.  For the street address, you can enter "Homeless."

Documentation

You will be expected to send support documentation for many of the requests for service. This will always include a form of ID.  Please hide/mark out the driver's license number and/or Social Security Number.   If you are having issues with uploading documents, add a request for "Client Support." 

Security:

The files provided are maintain in a secure environment.  You may add a password to the uploaded file.  Once an agency is assigned, you can share the password with the agency if needed.  If you forget the password, the uploaded file will not be viewable by an agency.

You can take a picture of the document with your phone, scan, or go to a local library to use their scanning equipment and internet service.

Financial Aid: Some agencies may require ...

1. Proof of Lease/Mortgage
2. Proof of Income - examples: paystubs, letter from employer, department of labor form, SSI award letter
3. Late notice and/or eviction notice
4. Recent utility bill in your name - Gas, Water or Electricity bill
5. Documentation proving crises - examples: hospital bill, temporary loss of employment, unexpected expense

If you have received financial aid in the past 12 - 24 months, some provider agencies may choose not to provide repeat assistance.  

Identification:  Most agencies require ...

Government issued picture ID - examples: Passport, Drivers License, State ID, Voter ID, Military ID, Tribal ID or Social Security Card

File Types and Sizes

The file type are jpg, jpeg, png, and pdf.  Please make the file size 5 Megabtyes or less.  If your file is too large to upload, you can crop the file, resize to make smaller, or compress the file so that you can upload.  The "Other" and "Your Picture" do not have file size restrictions.  We appreciate you helping us conserve digital space.

Government ID:

To expedite your request, use this section to upload required government issued photo ID - examples: Passport, Drivers License, State ID, Voter ID, Tribal, Military ID.  Remember to hide/protect the driver's license number or social security number.

or

Finacial Aid Documentation

Income Documentation

 Examples of income documation are paystubs, letter from employer, department of labor form, and SSI award letter.

Utility Documentation

 Examples of utility documation are gas, water, and power statements that include your name.

Crisis Documentation

 Examples of crisis documation are hospital bill, temporary loss of employment,  and unexpected expenses.

Other

Any other documents that are relevant for the service requested.  (No file size restriction for other)

Your Picture

Even if you provided an identification under "Photo ID", include your picture below.  This may expediate your request.  You can also use this option to take pictures of the documents that are not in a file format.  There is no file size restriction for photos.

For Shelter, please upload a recent photo of yourself if you did not include the above ID documents.

Additional Comments or Information Related to this Application

Method and Time to Contact

Please include the means of communication such as phone, email, text with day and times for contact for the next 10 days.   Indicate if you have a free telephone number that requires a specific type of app for communication.

Language Preference

If English is not your primary languague, specify your preferred language(s).

Other Income Source

If you selected "Other" for an income source, please explain below.

Other Documents Source

If you selected "Other" for documents, please explain below.

How to Submit the Request

To submit this request, click on the "Review" button.  You can print the form while reviewing or after the review.  

Once you have clicked on "Review", you will be able to hit the "Submit" button.  You will see a "Thank You" message when submitted.

This request will be matched with an available agency within 48 hours or less. If an agency is unavailable to provide services, you will receive a notification by email within 10 days.  If this is an emergency, go  to https://theconnectorwga.org/resources for immediate assistance suggestions.

 A copy of this request is automatically sent to the valid email if provided.  The attached images are not available for review except by The Connector Help Desk.

We are not able to view an application that is not submitted.

Where is the Review and Submit Button?

Once the request is submitted, you will get a screen confirming that the application is submitted.  You must answer all the required questions in order to see the "Review" button and the "Submit" button.

Reminder:  Add Email for Communication

If you have an email account, add the following contacts to my email list: help@theconnectorwga.org and no-reply@theconnectorwga.org. A response will be sent to you email, if provided, within 1 hour to 48 hours of hitting the "Submit" button. If you don't get a response, check your spam or junk folder. Failure to respond to an email from The Connector could result in delayed or canceled requests.