Request HELP

First/Last name followed by your Facebook name (if different from your legal name).*

How did you learn about the Emergency Relief Fund?*

Phone Number*

Email*

Please enter your current complete address even if it is a motel, including zip code.*

Do you rent? Own? Neither? Are you homeless?*

Are you currently employed?*

What is you average annual income including government benefits such as EBT?*

What is your ethnicity? White? Black? Hispanic? Asian? Other?*

How many children are living with you?*

Attach photographic proof

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If you are unable to attach a photo, please email it to us at support@helpstpete.org.

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Saint Petersburg, Florida, United States