This program was created to help those who financially require help from our community.
Please download and complete the following application form, sign and date it, and
then call the Coordinator to set up an appointment. A member of the Assessment Committee
will meet with you to verify the information you provide. You will need to provide
1. Verification of both income and expenses. For income, this will be your most recent
paystub and/or bank statement showing direct deposit of wages, social security income,
etc. For expenses, we will need your most recent rent or mortgage receipts and utility
2. Two forms of identification, one of which must be a photo ID. These may include
your DMV ID card, or Oregon Driver’s License, your social security card, military
ID, and/or a medical insurance card.
3. Bring your most recent Federal and State Tax returns.
You will be notified at a later time whether or not your application has been accepted.
THANK YOU FOR APPLYING FOR THIS PROGRAM!
IF YOU ARE A SHUT-IN, SPECIAL ARRANGEMENTS CAN BE MADE TO COME TO YOUR HOME FOR YOUR