Forms and Resources

Requirements for Social Services Assistance



To apply for any assistance please click on the following Intake Form & Related Documents link, print, and complete it. Do not date your application until you come into the office for your intake interview. Information pertaining to required supporting personal documents (bring originals not copies) and our office locations where you can submit these with your completed Intake Form are included in the linked document. Also included for you to complete are an Authorization for Release of Confidential Information and a Self-Sufficiency Assessment. Please follow all instructions.

Intake Form & Related Documents

Below are additional forms you may also need to download and complete, depending on your situation and the assistance you are seeking. See specifics below:

Move-In Confirmation Form – This form is used when you are requesting assistance for moving into a new apartment. The applicant fills out the top portion and the bottom portion is filled out by new landlord.

Residential Lease Agreement – This lease agreement can be used if you don’t have one with your landlord. A current lease is required for rental assistance.

Employment Verification Form - If you have recently started a new job and have not yet received a paycheck, please have your new employer fill out the Employment Verification Form below.

Work History Form - If you have been unemployed in the last 30 days, please complete the Work History Form listing the companies you have applied to for work.

Discount Programs



Telephone Assistance Program (TAP) Application - Please note the Doctor’s Form included in this application that needs to be submitted to apply for the TAP Program.

Lifeline Telephone Discount Form

Senior Telephone Discount Form

Resources



Housing Directory – List of apartments in Flagstaff.

Resource List - List of Flagstaff’s Local Service Providers.

Supplemental Nutritional Assistance Program (SNAP) (formerly Food Stamps) - To apply for this assistance click on this link, then click on “Begin Now” to start application.