Junior Auxiliary of Hattiesburg Financial Assistance Request

Junior Auxilliary of Hattiesburg is commited to meeting the needs of women, children, and underserved populations in the Hattiesburg Community. While we work to meet every rquest possible, we do have to follow guidelines so that our funds are allocated aappropriately. This assistance is not limited to individuals. Non-profit organizations, schools, etc that provide services to women and children and other under-served populations in the Pinebelt are also able to apply.

Guidelines:

Utlility assistance will not be considered until after the 15th of each month. Maximum utility assistance of $150 if funds allow or minimum to keep service active. We do not pay deposits.
Rent assistance will not be considered until after the 15th of the month. Maximum assistance of $400 if funds allow.
We do not provide assistance with car note or loans.
Submissions are evaluated by a committee on a case by case basis in which multiple factors are considered.
Individuals will only be considered ONCE PER calendar year.
Indivdual request will be denined if you have received assistance for two consecutive years.
You will be contacted within 3-4 business days regarding the status of your request.
Once your request is approved, you will have 10 days to receive the financial assistance. If the assistance is not picked up within the 10 days, your request will not be fulfilled.

Name of individual submitting request:

First NameLast Name

Phone number for individual submitting request:

Please enter a valid phone number.Format: (000) 000-0000.

Email for individual/organization requesting assistance:

If you are submitting for someone else

I am submitting this request on behalf of myself:

If no, please list the name of the individual or organization you are submitting on behalf of:

I am submitting as an:

Address of Individual or Organization Requesting Assistance:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If you are an individual requesting assistance, are you employed?

Please tell us what type of assistance is needed: (utilities, food/nutrition, child related, clothing/footwear, etc). Please give us the amount being requested and what that amount is for. (For example, if you need utilities, tell us the amount you need and how long a time period that amount is for.)

Amount of Assistance Requested:

If you are requesting rent assistance, who is your landlord/property manager?

What is their phone number?

Please enter a valid phone number.Format: (000) 000-0000.

If you are requesting utility assistance, list your utility provider AND account number.

Please give us some background information on the situation that caused the need for assistance. Please provide as much information as possible so we can best understand the need being requested.

Please provide a character reference that is outside of your family. References will contacted to verify the severity of the need.

Phone Number for Character Reference

Please enter a valid phone number.Format: (000) 000-0000.