Are you finding yourself struggling to make ends meet? United Way of St Clair might be able to assist you. Please complete our pre-screen application and let us know about your struggles. Complete our Pre Screening Form You must have JavaScript enabled to use this form. Full Name Phone Email Address How long have you lived in St. Clair County? How many people are in the home (How many adults, How many children)? Are you a veteran? Yes No Reason for application ( Examples: Illness/Medical Hardship, Loss of Job, Crisis/Unexpected expense, Reduced Wages/Work Hours) Please provide a brief summary for your situation explaining the need: DHHS & Other Agency Support: Are you a client of DHHS? Yes No Have you applied for assistance regarding your emergency? Yes No Do you have a Decision Notice from DHHS/other agencies on this matter? Yes No Other agencies you’re receiving help from: Employment Information: Household Name of who is employed Employer Name How long have you worked for this employer? If unemployed, how long ago since you worked? Submit Leave this field blank
