The EOC of Suffolk County Emergency Assistance Program Application

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EOC Suffolk – Emergency Assistance Program Application

Emergency Assistance Application

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First Name*
Last Name:*
Phone
Address
Street Address City State / Province / Region Postal / Zip Code Country
Household Size:
Children (under 18)
Yes
No
1 - Have you been impacted in any way by the COVID-19 pandemic? (If yes, please describe how below)
Yes
No
Textarea
2 - Please describe the type of financial assistance you are seeking: (Please include exact amounts)
3 - Please describe the cause of your financial hardship/current situation: (please include how you fell behind)
4 - Describe what type of assistance you’ve attempted to access before seeking assistance through EOC’s Emergency Assistance Program, including what personal resources you’ve used:
5 - List all current income for all household members:
6 - Long-Term Recovery Plan: (Describe how you intend to gain stability and maintain your needs once assistance is provided)
Enter Verification

Programs & Services

Chronic Health Care Coordination
Community Based Initiative
Emergency Assistance
Family Development
HIV/AIDS/HIV(-) Targeted Prevention & Support
Housing Programs
Montauk Child Care
Rapid Rehousing Program
Services for People With Developmental Disabilities
SNUG Violence Prevention
Suffolk County Family Court Children's Nursery
Supportive Services For Veteran Families
Way To Grow Child Care Learning Center
Wyandanch Weed and Seed
Youth & Adolescent Services

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Quick Numbers

Commissioner's Response Unit: 631-854-9935 / 9936
Emergency Services: 631-854-9100
Fair Hearings: 1-800-342-3334
Welfare Fraud Hotline: 631-854-9815 / 9807
Burials: 631-854-9856
Assets and Resources: 631-854-9858

Copyright 2019 The Economic Opportunity Council of Suffolk, Inc | Board Only | Staff Only | Phone: 631-289-2124

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