Pay it Forward Application

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Referrer / Case Manager Information

Receiver Contact Information


Work / School Information

Work Address*

Family Information

What Assistance Do You Need?

Pay it Forward

As part of the Pay it Forward program all applicants are required to "Pay it Forward" or give back to the community, their family or enrich themselves as a way of giving back to their family. Some examples include:

  • Taking a parenting class.
  • Taking an English as a second language class.
  • Helping at a local food bank or charity organization.
  • Volunteering with the Meals on Wheels program.
  • Volunteering (visiting) at a nursing home.
  • Finding a relevant community resource for your family and using it.
  • Donating your time and/or skills to a neighbor or someone in need.
  • Volunteering at your church.
  • Joining a free support group.
  • Enrolling your child in a program like Big Brother.

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