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Please complete the form below
to apply for financial assistance 

Not all of our programs cost money to register for. The money received from services such as Resume Building and Family Planning are used to build our Stable Housing Initiative and Financial Aid for families in need. 

Fee Waiver Application

Please complete the fields below to be considered for a fee waiver. If you do not qualify but still can not afford to pay for any services, please complete the form anyways, as we are here to help and will work with you to access the support you need.

Are you currently receiving CalWorks or CalFresh?
If so, which services are you currently recieving from the HSA?

We require an upload of your proof of benefits document OR an image of your EBT Card.

You do not need to upload both.

Upload File
Upload supported file (Max 15MB)
Upload Image
Upload supported file (Max 15MB)
Which programs are you interested in? Required
Are you interested in volunteering with us?
Are you willing to email or text a few people a provided template about our charity if you are approved for a fee waiver?

Thanks for applying! You will hear back from us within 3 days.

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