Covid-19 Relief Assistance

If you have lost hours of employment or your job due to Covid-19 and are in need of Covid-19 Relief Assistance with rent/mortgage and/or utilities or prescription assistance, please fill out the attached Emergency Assistance Application.

You must provide proof of income loss with pay stubs before, during and after the Covid-19 period and a letter from your job stating you were off work due to Covid-19.

Once the application has been received, the Agency will require the following documents to be submitted.

  1. Copy of driver’s license for all adults listed on application.
  2. Copy of social security card for every member of your household, including children.
  3. Lease or mortgage payment information (copy of lease agreement or mortgage statement)
  4. Current utility bills
  5. Evidence of loss or change in income due to COVID-19
    • Notice of furlough or layoff; or
    • Self-statement of job or income loss
    • Proof of income before and after showing a reduction in income

I certify that my total household income based on the household size is no greater than:

Persons in Household 1 2 3 4 5 6 7 8
Income Limit $25,520 $34,480 $43,440 $52,400 $61,360 $70,320 $79,280 $88,240

* This opportunity is available only to those households with incomes at or below 200% of poverty as defined by the US Department of Health & Human Services

Opportunities, Inc. will pay no more than $1,000.00 per household for utilities, rent, mortgage or a combination of both.

Once the application is approved. it will take 5 business days to process the payment to the vendor on your behalf.

An applicant can also apply for prescription assistance.

Coronavirus Aid, Relief and Economic Security Act Emergency Services Application

Although multiple sources might be necessary to cover client’s expenses due to COVID-related job loss or medical hardship, client must not receive duplicative benefits over and above outstanding balances presented at the time of this application.

If you receive subsequent duplicative benefits (an amount over and above your stated current need) from other entities for requested need of Opportunities, Inc., you agree to repay Opportunities, Inc. the total amount received.

If you agree to the above statements, then complete the application below.

  • Address

  • Amount Past Due

  • If applying for Rental/Mortgage Assistance, please provide the following along with late or eviction notice:

  • Max-upload limit: 24MB
  • Adults

    Please use the plus sign at the end of this section to add every individual living in your household including applicant.

  • Name# of Months With No IncomeEnter Job Monthly IncomeAmount Monthly Social SecurityAmount Monthly Supplemental IncomeAmount Monthly Disability IncomeTanf (Adult W/Child)Public Asst.PensionVeterans RetirementRentalChild Support 
  • Please list all persons living in Household

    Please use the plus sign at the end of this section to add every individual living in your household including applicant.

  • First NameLast NameSocial SecurityChoose OneSexDate of BirthStatusDisabledEducationVeteran StatusCitizenship StatusInsurance: Check One That AppliesRace