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Apply for Service

We can provide service for:

  • rental housing issues
  • social assistance issues
  • employment issues
  • immigration issues

In order to qualify your income must be below:

Family Unit SizeTotal Family Income
1
$22,720
2$32,131
3$39,352
4$45,440
5$50, 803

Please complete this form as fully as possible.

Depending on the urgency of your matter (upcoming hearings, deadlines), it may take up to three business days of a member of our staff to follow up with you.

If you have one, please provide a phone number and an email address so we can more easily reach you.

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Contact Information

Address

If you are at no current fixed address, please enter the closest intersection to your current location.
Address
Voicemail OK?
Email Communications

Income

We can only help people with low incomes. However, if your income is too high, we may still be able to provide you with summary advice and discuss referral options.
What is your main source of family income?

Statistical Information

This information does not impact whether you receive assistance from us, and is only collected to help us better understand the communities we serve.

More Information

Language Spoken
Interpreter Required

Area of Law

What sort of problem do you have?

Details of Issue

Click or drag files to this area to upload.You can upload up to 5 files.

Did Anyone Refer You to Us?

Date / Time