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Solicitud de asistencia para el alquiler

Please use this form to apply for Rental Assistance. Fill out as completely as possible. Thanks.
Utilice este formulario para solicitar asistencia para el alquiler. Complete lo más completamente posible. Gracias. Después de tus cambios, el clic en el botón “Submit” para enviarlo.

OR – download and print this PDF so you can fill it out and mail it: 

2025 Dual Language Crossroads ApplicationDownload
Do you have any household income? (Employment, child support W-2, etc)
Do you currently reside in Watertown?
Are you only one or two months behind in rent?

If you answered NO to any of these questions, you may not be eligible for Crossroads Rental Assistance.

If you answered Yes to all of these, please submit the following with your application.

Application must be entirely filled out to be considered.

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.
Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.
Drag & Drop Files, Choose Files to Upload You can upload up to 9 files.

#1 – Household Demographics

Household Occupants Information

#2 – Employment

Are you and/or anyone in your household employed for pay?
Does your current household income provide enough income to support yourself & your family?

#3 – Financial Information

#4 – Government Benefits

Are you receiving any government benefits?

Financial Assistance

How much do you receive from each of these?

Have you received assistance from Crossroads in the past?

#5 – Monthly Expenses

Please give a dollar amount for the following monthly expenses. If you have a back amount that is owed, please list that amount in the second column.

Health

Do you have any current health issues?
Please describe the events that happened to cause you needing assistance.

AUTHORIZATION FOR RELEASE OF INFORMATION

This authorization allows Crossroads committee to release/obtain/exchange information with any of the following organizations and includes our corresponding with your landlord.

Watertown Unified School District
Watertown Head Start
Watertown Dept. of Public Health
St. Vincent de Paul
Salvation Army

Please add the church name
Typing my name here is my signature
Alternate Phone - In case we cannot reach you at the number given, is there another number where we might be able to get in contact with you?