30 October, 2020 Application For Relief Please fill out the below information for initial relief screening. A NewFit Member will reach out to you via email/phone to work with you. Application for ReliefPlease enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth *Email *Address *Phone *Military VeteranYesNoTotal Members in Household, if ApplicableIncome - Do you and/or people that live with you receive income?YesNoMarital StatusMarriedSingleName of SpouseEmployment StatusEmployedSelf EmployedUnemployedStudentIf Unemployed, are you currently recieving any Unemployment benefits?YesNoEmployer (If Married, you may include Spouse Employer)Income Level (Annual Salary)Unemployed or Displaced Worker0 - $30,00031,000 - 50,00050,000 - 70,000Description of Housing Status (Where do you currently live?)Home/ApartmentLiving in Hotel/Motel/Transitional HousingLiving in ShelterHomelessDescription of Relief RequestFood AssistanceRent/Utility Bill AssistanceHomelessness PreventionEducational or Technical ResourcesBusiness ConsultationJob Training/PlacementOtherDescribe Relief Request (State reason why your are requesting relief)Submit