Neighborhood House Help Form

2. How may we contact you? *This question is required.

• Email
• Phone

5. What do you need help with:
  *This question is required.

• Applying for employment and training services
• Applying for DSHS cash assistance (TANF)
• Applying for food stamps (SNAP/EBT)
• Applying for health insurance
• Accessing food assistance
• Accessing mental health or substance use treatment
• Currently housed and seeking rental assistance
• Currently homeless (in shelter, car, tent, etc.) and seeking housing services
• Youth afterschool services
• Youth tutoring services
• Citizenship application and classes
• Early childhood education and resources (up to 5 years old)

6. Are you a resident of the following housing authorities?  *This question is required.

• King County Housing Authority
• Seattle Housing Authority
• Not Applicable

7. Are you or someone in your household a community college student? *This question is required.

• Yes
• No

7. Are there children under age 18 in the household? *This question is required.

• Yes
• No

8. Are the children in the household students in either the Highline or Tukwila School Districts? *This question is required.

• Yes
• No

8. Are the children in the household students in Seattle Public Schools?

• Yes
• No

8. Are you over age 55? *This question is required.

• Yes
• No

9. Do you have a disability?  *This question is required.

• Yes
• No