Request Housing Support

About us
Causes
Shop
Blog
Contact

Request Housing Support

Housing Support • Waiting List • Intake Form

Housing Assistance Request

Use this form to request housing support and join our waiting list. We review requests based on urgency, eligibility, and available resources. Submitting this form does not guarantee housing assistance.

Waiting list intake

Emergency referrals (if available)

Rental/utility support (limited)

Case-by-case review

Important

This is a waiting list intake form.
Approval is not guaranteed.
We may provide referrals if assistance is unavailable.

If you are in immediate danger, call 911 or local emergency services.

Applications Open — Limited Funding

CTC serves residents of the nine San Francisco Bay Area counties. Financial assistance is limited, subject to verification and available funding, and is not guaranteed.

Housing Program Summary

Eligible households may receive up to $2,500 for approved rent, primary-residence mortgage, security-deposit, first-month rent, or housing-stability needs. Financial assistance is normally limited to once every five years per household. Navigation and referrals may be provided more frequently. Approved payments are normally made directly to the verified landlord, mortgage servicer, property manager, or provider.

Review the Program Assistance Terms & Conditions

Applicant Information

Full Name *

Email *

Phone *

ZIP Code *

Bay Area County *

City *

Household Information

Adults in Household

Children in Household

Preferred Language

Safest Way to Contact You

Housing Assistance Requested

Select all that apply *
Past-due rentPast-due mortgage on primary residenceSecurity deposit / first month’s rentHousing navigation or referralHousing-related utility assistance

Amount Requested

Important Deadline

Current Housing Status *

Urgency

Prior Assistance and Financial Need

Has anyone in your household received financial assistance from CTC before? *

If yes, approximate year

Employment Status

Monthly Household Income Range

Explain the Emergency

What unexpected event created this housing crisis, and what assistance is needed? *

If assistance is approved, how do you expect to maintain the housing going forward? *

Potential Payee

Landlord, property manager, or mortgage servicer name

Payee phone or email, if known

Initial screening only

Do not upload or enter a Social Security number, bank account, passport, immigration status, or government identification. If the request advances, CTC may request limited documents through a secure process.

I certify that the information provided is complete and accurate to the best of my knowledge.

I understand that assistance is not guaranteed, may be less than requested, depends on available funding, and is normally limited to $2,500 once every five years per household.

I understand that approved funds are normally paid directly to a verified landlord, mortgage servicer, property manager, or provider and not directly to me.

I authorize CTC to contact me and verify relevant information with the listed housing provider for the purpose of reviewing and processing this request.

I have read and agree to the Program Assistance Terms & Conditions and Privacy Policy.

Emergency Notice: This form does not provide immediate shelter or emergency response. If you are in immediate danger, call 911. For urgent community resources, call 211.

What This Form Is

An intake form to join our housing assistance waiting list. We may contact you for follow-up, verification, or referrals.

Tip: Include key dates (eviction/shutoff) and the type of help you need most.

What We May Support

Based on availability:

Housing referrals
Navigation/case management
Limited rental or utility support
Limited repairs assistance

Emergency Resources

If you are unsafe or need shelter immediately, call 911 or contact local emergency housing services in your area.

Stay Connected With Our Impact

Empowering Families in Concord, the Bay Area, and Communities Worldwide

Quick link

About us
Volunteers
Careers
Partners
Terms of Use
Privacy Policy
Contact

Donate

Donate Goods
Donate Technology
Donate Food
Donate Vehicles & Property
Donate Emergency Supplies

GET HELP

Request Food Assistance
Request Education Grants
Request Housing Support

Donate now

Privacy Settings

We use essential technologies to operate this website. With your permission, we may also use functional, analytics, and marketing technologies. You can accept, reject, or change your preferences at any time.

Essential Functional Analytics Marketing