Assistance Application | Kingdom Family Min.

Application For Assistance

At this time, assistance for utilities and groceries is provided to families with children in Montgomery County, Texas only. Our marriage support program is open to all of Montgomery County and parts of North Harris County.

Please submit one application per assistance request. While you can seek aid from various programs, only one application will be accepted. Each family is allowed one approved application per year.

We aim to support families to the best of our ability, yet due to limited funding, we have set limits to the amount of assistance given.

Today's Date

Contact Information

First name

Last name

Street Address

City

State

Postal / Zip code

Phone

Emergency Contact Name

Emergency Contact Number

Demographic Information

Birthday

Household Information

Spouse's Name:

Spouse's Phone:

Please list all family members and include name, date of birth, gender, age, race and relationship to applicant:

Financial Information

Employed Household Member Name:

Household Member Place of Employment

Total Gross Income (the amount before deductions) of all household members is:

Indentifiction such as driver's license or state ID.

Upload File

Proof of residency such a lease agreement or utility bill.

Upload File

Disconnect notice if applying for utility assisance.

Upload File

I, the undersigned, hereby authorize the release of information to Kingdom Family Ministry board of directors for the purpose of determining program eligibility and monitoring program compliance.

Yes, I accept.

Please let us know how you learned about KFM- Facebook, Interent search, or word of mouth (who or what agancy).

Your Signature