Because stability can’t wait.
Start here to request urgent support for rent, utilities, or both.
This form helps us understand your situation so we can respond quickly and fairly. Please complete all required fields — incomplete applications will not be considered. If selected, you’ll be contacted for a virtual intake interview. Your information remains confidential and is used solely to determine eligibility for assistance.
Emergency Assistance Application Form
Section 1: Basic Applicant Info
Section 2: Type of Assistance Requested
Section 3: Utility Assistance Details (if selected)
Section 4: Rental Assistance Details (if selected)
Section 5: Household & Financial Info
Section 6: Next Steps
Final Confirmation
I confirm that all information provided is accurate to the best of my knowledge. I understand that if selected, I will be contacted by InspireU Foundation for a virtual interview to complete the intake process.
I also understand that the completion of the application doesn’t guarantee assistance.
If selected for assistance, I understand that I have 72 hours to submit the required documentation. If I don’t send in the documentation, my spot will be forfeited.
