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His Ministries Intake Information

All meetings are by appointment only. On completion of this form, you will contacted within 3 days to book an appointment.

Our hours of operation are Monday, Wednesdays, and Saturdays 9:00am to 12:45pm.

 

4205 Jackson St.

Santa Fe, TX 77517

 

Feel free to call or email us:

409-925-4697

jenn@hisministries-sf.com

 

ATTENTION ALL POTENTIAL CLIENTS

His Ministries is excited to be able to potentially provide Emergency Assistance with utility payments, partial rent, and other emergency assistance ONCE per Calendar Year.

 

All individuals requesting Emergency Assistance are asked to provide the following information for the entire household to qualify for the assistance:

  1. Complete Application

  2. Proof of ID(s), Social Security Card(s), and Address

  3. Copy of Utility Bill and/or Lease Agreement

  4. Proof of Loss of Wages

  5. Proof of Income

 

All applicants must live within the Santa Fe ISD to receive assistance.

Date of Birth
Month
Day
Year
Select ONE of the following:
Married
Separated
Single
Divorced
Widowed
Are you employed?
Yes
No
Date of Last Employment
Month
Day
Year
Are you registered with Texas Work Force?
Yes
No
Type of Residence:
House
Apartment
Trailer
Do you own or rent?
Own
Rent
Your monthly income source, select all that apply:

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Type NA if Not Applicable.

Adult's FULL name

Relationship

DOB

Gender

Age

Social Security Number

Children's FULL name

Relationship

DOB

Gender

Age

Social Security Number

I am seeking assistance with the following: Select all that apply.
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