Get Started | The Help Squad Cincy

Welcome to The Help Squad Assistance Program Client Request Form

The Help Squad Assistance program is based on funding availability and
this form will no longer be available when we meet our Quota.

The new DRIVE Car Repair Program is only available to those in the Help Squad Service areas or
experiencing Homelessness who are enrolled
in a prevention program with
Strategies to End Homelessness (STEH) Shelter Program.
*****Due to the Overwhelming response of those in need
please be patient
as it may take several days for a response.

First name

Last name

Email

Phone

Street Address

City / OH

Zipcode

Birthdate

Do you live in one of these 4 Areas? Check the box ****Call 211 for Assistance outside of these areas

Colerain Township

Green Township

Delhi Township

Cheviot

Financial Aid is for Qualified Working Families with Children in the local school districts we support, Senior Citizens and Veterans only. Please call 211 if you do not qualify. What is the Amount of Financial Aid Needed for this Emergency?

Explain the setback you experienced and why you are requesting assistance?

Are you facing a disconnection? List the Utility Company, Account Number and Disconnect Date.

Do you need Rent or Mortgage assistance? Check below

No, Not Applicable

Rent

Mortgage

What Date is the Rent Due?

Have you received an Eviction Notice or have a prior Eviction?

Are you currently Homeless?

No

Yes

If you are Homeless, please register with the Shelter Network Call 513-381-7233)

No

Yes

Have you received assistance from The Help Squad in the last 12 months?

No

Yes

How many adults live with you?

1

2

3

4+

List Adult Names and Ages

How many children live with you (under 18 years of age)?

1

2

3

4+

List Children Ages/Gender

List School(s) Your Child Attends & Referred you to The Help Squad

List your total monthly Income (Must itemize each source, Employment, SSI, Child support, Alimony)

List your monthly Expenses and amounts owed (Must Itemize)

Are you a US Citizen or do you have a green card, work permit, or student visa?

No

Yes

Does any member of your household have a disability or special need?

No

Yes

Were you referred to The Help Squad by another organization or agency?

No

Yes

List referring organization/agency

Are you working Full-time?

No

Yes

Part-time

Place of Employment

Not working full-time? Explain Why?

How many hours do you work?

<10

10-25

25-39

40+

How many other adults living in your household work at least 36-40 hours per week?

0

1

2

Are you a Veteran?

Yes

No

Are you enrolled in pre courses for a GED or at a college or trade school?

Yes

No

What is your plan to get back on track and stay on track?

If assistance is approved you will be required to take a financial management class; Is this something you will commit too?

Upload a copy of your lease, mortgage, 2 paycheck stubs for each adult in the home working, eviction notice, utility bill, car payment/insurance bill or any paperwork to support your request. You can email questions to: contact@thehelpsquadcincy.com

File upload

“I never imagined myself in this position with 5 kids and no where to turn. Thank you for being there for me and helping me through this. I have a job, daycare vouchers, food, housing and hope because you cared. I want to come back and help others who are hurting like I was…..”

“I never imagined myself in this position with 5 kids and no where to turn. Thank you for being there for me and helping me through this. I have a job, daycare vouchers, food, housing and hope because you cared. I want to come back and help others who are hurting like I was…..”

Mother of a NWLSD family