This form will be collected and added to our assistance registry so that we may
contact you as soon as we are able to help
*If able, attach a photo of the bill below showing name submitted
*If able, attach a photo of the bill
below showing name submitted (must be urgent or shut-off notice)
*Please attach a photo of your valid Driver's
License with name submitted shown
*Thrift store hours will be set by appointment
*Please check DSHS to apply for a voucher,
voucher's will be covered dependant on our resources
By clicking submit, you agree that all the information above is accurate and valid.
Sorry, it seems that you're out of the Outreach's range.
We have additional resources available for you to check. If you want to proceed,
click continue, otherwise click close.
To ensure we can give the resources needed, please make sure the information above is accurate.
Additionally please note our hours of operation at the bottom of the page.