Utility & Rental Assistance Program

Homeward Bound can provide utility and rental assistance funds for qualifying Phoenix families effected by COVID-19.

WHO IS ELIGIBLE?

Renters must live in the City of Phoenix, AND

Must be in a current 6-12 month lease

Be 18 years or older or an emancipated youth, AND

Have an income at or below 30% of the Area Median Income*, AND

The household has been financial affected by COVID-19 (be prepared to show proof of hardship), AND

Housing is unstable or at risk (past-due rent, utility notices, or eviction notice)

Area Median Income Eligibility Chart

If eligible, assistance may be available to you. Please complete the inquiry form below to hear from a Homeward Bound staff member within 5-7 business days.

Click on the button below for a list of documents each adult in the household will

need to provide with your application upon eligibility approval.

If you have any questions about the form please contact prevent@homewardboundaz.org.

Eligibility Inquiry Form

Your Personal Information
Please let us know how to get in touch with you.
Your Name*
First Last
Other names used
First Last
Your Email Address*
Your Phone*
Current Address*
Street Address Address Line 2 City State ZIP Code
How did you hear about us?*
Eligibility Questionnaire
Please answer the following questions to determine your eligibility.
Are you 18 years of age or older OR an emancipated youth?*
- Yes
- No
How have you been financially affected by COVID-19?*
Please be prepared to show proof of documentation of job loss, dock in pay, cut hours etc.
How many adults live in your home?*
How many children under the age of 18 live in your home?*
Are you currently employed?*
- Yes
- No
If yes, where are you currently employed?
How much income have your received from this employer in the last 30 days?
Income Within The Last 30 Days
Please write in the amount you received within the past 30 days in the boxes that apply to you. If you don't receive one of the mentioned, please type in "0". Total all the income for the adults in the household. If two adults receive SSI write the total between the two adults.
SSI or SSDI*
Alimony*
Child Support*
Cash Assistance*
Unemployment*
Other*
What was your total household income for the past 30 days?*
Combined total for all family members receiving income.
What assistance are you seeking?
Please let us know which assistance you are requesting.
Have you received a past due or eviction notice in the past 30 days?*
Please be prepared to supply a copy of the notice.
- Yes
- No
Please select the type of lease you are in or applying for:*
Rental Assistance*
Please choose all that apply.
- Monthly Rent Payment
- Move-In Deposit
- Not seeking rental assistance at this time
Monthly Rent Payment*
If you chose this option, please put the amount of your payment. If not seeking rental assistance please type "0"
Move-In Deposit
If you chose this option, please put the amount of your payment. If not seeking rental assistance please type "0"
If you are requesting a move-in deposit, what is the address you are moving to? **Must be a Phoenix, AZ address.
If you are not seeking a move-in deposit, please move on to the next question.

Street Address Address Line 2 City State ZIP Code
Utility Assistance - Please fill in amount where applicable.
Gas*
Please put the amount of your payment. If not seeking utility assistance please type "0"
Electric*
Please put the amount of your payment. If not seeking utility assistance please type "0"
Water*
Please put the amount of your payment. If not seeking utility assistance please type "0"
Utility Deposit*
Please put the amount of your payment. If not seeking utility assistance please type "0"
Other*
If you chose other, please specify the utility bill you would like paid and the amount. Ex: Gas - $50 If not seeking utility assistance please type "0"
If you are requesting a utility deposit, what is the address you are moving to? **Must be a Phoenix,AZ address.
If you are not seeking a utility deposit, please move on to the next question.

Street Address Address Line 2 City State ZIP Code
Please sign your full name here to complete the eligibility form.

Address

Homeward Bound

2302 West Colter Street

Phoenix, AZ 85015

Hours

Mon – Fri: 9am to 4pm

Sat – Sun: Closed

Tel: (602) 263-7654
Fax: (602) 265-4006

Tax ID

We are a 501(c)(3) nonprofit
Our tax ID is 86-0660875

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Homeward Bound provides accessibility to information, participation, services and employment for handicapped persons. Information is available for the hearing impaired by calling 602.261.8899 (TDD). Homeward Bound will not share or sell any donor’s personal information with anyone else, nor send donor mailings on behalf of other organizations. It is the goal of Homeward Bound to implement equal opportunity policies for all applicants without regard to race, religion, color, sex, age, national origin, disability, sexual preference, familial status or veteran status. In addition, Homeward Bound is committed to providing program participation with reasonable accommodation to qualified applicants with disabilities.