Personal Grants Application Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Date of Birth *Email *SSNCellphone number *Gender *Select oneMaleFemaleRace/EthnicityWhitePacific IslanderBlackAsianAmerican IndianMiddle EasternHispanicSexual OrientationVictim of A Crime as an AdultPhysical AssaultMonetary theftSexual AssaultRegarding the (alleged) Perpetrator: Was there a Felony Conviction?Choose your answerYesNoRegarding the (alleged) Perpetrator: Misdemeanor Conviction?Choose your answerYesNoIf so, Are you willing if need be, to provide info for court/and or other records?Name/City or County/State/datesApproximate Monthly Rent PaymentApproximate Monthly Mortgage PaymentApproximate Monthly Home Gas BillApproximate Monthly Home Water BillApproximate Monthly Home Electric BillDo you take care of another person - in home, or outside your home – or both/more than 1 person?Choose your answerYesNoFinancial Hardship Grants – Is your income, factoring any and all dependents, below the declared poverty line to the best of your knowledge?Choose your answerYesNoEmergency Funds – Are you currently financially destitute?Choose your answerYesNoDo you need grant(s) for a down payment or closing costs, other, for a new home purchase? *Choose your answerYesNoAre you open to receiving a forgiveness loan for a new home or other? *Choose your answerYesNoConditions apply, for example, you may have to live in the home for a number of years in order for the loan to be forgiven n(1-10 years, many times depending on the size of the loan)? Notice, We cannot charge a percentage on a loan made to “consumers”, but we do have a tiered separate flat fee billing for the “loan forgiveness” aspect of the agreement and is due after approval and varies between 10%-15% of the proposed forgiven amount. If you violate the conditions, that does not affect our fee.Submit