Family Assistance Application
Please use this form to submit the requested information about a family in need within our community.
Requestor Information
Recipient Family Information
By signing my digital signature, I hereby declare that all the information provided on this applications is true and correct to the best of my knowledge and belief. I understand that if any information provided by me is proved false/not true, my application may be rejected/denied.
Please upload any supporting documents relevant to your application.
This is optional.
Your submission was not successful. Please be sure to answer each of the above questions and try again.
The Board Members of Raising the House will meet and review the application. We will notify the family if assistance can be given.
**All applications are kept strictly confidential.**