Emergency Assistance Funds
Available Form

As a comprehensive information and referral program, many requests United Way 2-1-1 receives are for utility and rent assistance. If your agency would like for United Way 2-1-1 not to refer callers to you when you do not have funds, please fill out the form below and the information will be updated regularly in our database. This information can be submitted as often as you like. Please answer all questions below with one of the following options:

• Yes = we have funds and want United Way 2-1-1 to make referrals for this type of assistance right now
• No = we do not have funds and/or would not like UW 2-1-1 to make referrals to this type of assistance right now
• N/A = we NEVER provide this type of assistance

Request Form: