Food Assistance Form

Significant Rent Increase: "Due to a significant increase in my rent, my monthly budget cannot cover both housing and food expenses."

Utility Shutoff Notice: "I received a shutoff notice for my electricity and had to pay to avoid disconnection, leaving me without enough money for food."

Unexpected Repairs: "I had to pay for unexpected home repairs, which drained my funds needed for essentials like groceries."

High Medical Bills: "I incurred high medical bills after an emergency surgery, which has made it difficult to afford groceries."

Lost Wages Due to Illness: "I was unable to work for several weeks due to a severe illness, impacting my ability to buy food."

Chronic Illness Needs: "I have ongoing medical expenses for a chronic illness, which significantly limits my ability to spend on other necessities."

Recent Job Loss: "I was recently laid off and am currently seeking employment, but my savings are depleting."

Reduced Hours at Work: "My work hours were significantly reduced, affecting my monthly income and ability to buy adequate food."

Seasonal Employment: "I work in a seasonal industry and am currently out of employment until the next season starts."

Temporary Homelessness: "I am currently without a permanent home and staying in temporary shelters."

Unsafe Housing Conditions: "My current living situation is unsafe and requires me to seek alternative shelter, impacting my financial resources."

Transitioning from Homelessness: "I am transitioning from homelessness and struggling to manage initial basic living costs."

Family Illness: "As the sole income earner, I need to support my family member with a serious illness, affecting our financial flexibility."

New Family Responsibilities: "I recently became the sole provider for my family due to unforeseen circumstances."

Income Insufficiency: "My income is not sufficient to cover all our living expenses, including food, as the only earner in the household."

Job Relocation: "I had to relocate for a new job opportunity and the moving costs have temporarily impacted my financial stability."

Eviction: "After being evicted, I've had to use all my savings on securing new housing, leaving little for food."

Fleeing Domestic Violence: "I recently fled a domestic violence situation, which led to immediate and unforeseen relocation expenses."