APPLICATION FOR ASSISTANCE

RJ Foundation Outreach is a non-profit organization providing supportive assistance. Please complete the following form

First name

Last name

Address

Phone

DL#

Date of Birth

SSN#

Number of ADULTS in your household?

Number of CHILDREN in your household?

EMPLOYER - Name, Address and Phone Number

Please choose one income-based utility service you are applying for:

Please select ONE of the additional services you are requesting:

Financial assistance is provided directly to the landlord or utility company. Please enter your Landlord OR Utility Companies Name, Phone Number and Account # (if applicable)

Please upload a copy of the following documents: PDF, WORD or JPG file format.

Drivers License or State ID

Birth Certificates (For children 15 & Under)

Proof of Income

Utility Bill (Such as Lights, Water, etc)

Additional Upload Space as needed

By signing below, I hereby acknowledge that I am 18 years or older, the information provided is correct, complete and true, and I am legally authorized to submit this information on behalf of my household.

Signature

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MUST READ BEFORE SUBMITTING

Submission does not guarantee approval. Upon receipt of required information, your application will be reviewed for possible approval.

For any questions, feel free to contact us at https://www.therjfoundation.com/about or email us at contactrjfoundation@gmail.com

APPLICATION FOR TOY DRIVE

The Rj Foundation and Rivers, along with a few other Sponsors, are coming together this season to be a Blessing to Young Mother's with children for the holidays. If you would like to submit an application, please read the requirements and complete the form below. Thank you

Christmas Toy Drive Registration Requirements

(This is a Church Connected Program for Assistance)

1. You MUST attend 10:30 am Church Worship Service at:

The Rivers of Living Waters Church

508 N Gray Street Killeen, Texas 76541

2. After the service is over you MUST meet inside of the Fellowship Hall so that we know who you are.

Christmas Toy Drive Application