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Help Application
Angels Application Form
UPDATE- As of Dec 2nd, 2022 we are fully booked for the month of December. We are working hard on our Christmas Outreach for over 700+ Children and Senior Citizens. We only taking emergency appointments up till Christmas and then will reopen the clothing closet after January 15. If you are a caseworker / agency with an emergent need, please fill out the form below and contact us for possible help.
Yes I understand Angels is only taking emergency appointments in Dec and will reopen the clothing closet after Jan. 15th
Angels Community Outreach is located in Pitman NJ 08071. Please only fill out this form if you are local to the area. LOCAL means you live near and can come to our location in person. You do not have to live in Pitman.
Yes, I am local to the area.
We will help as many people as possible. PLEASE Check below that you understand that filling out this application DOES NOT guarantee help/services.
Yes, I understand that completing this form does not guarantee assistance
Are you a past or current client of The Angels Community Outreach?
Yes
No
What help are you in need of? PLEASE NOTE: We are switching clothing from Summer to Fall/Winter. We will start clothing appointments back up mid to end of Sept. If you are in an emergency situation for clothing, please TXT us at 856-625-8652 to see how we might be able to help.
Clothing
Food
Toiletries
First Name
Last Name
Your Birth Date (example 09/20/88)
Address
Address Line 1
Address Line 2
City
State
Zip Code
Phone/Mobile
Your Email
Are you working at this time? This information will help us match assistance for you.
Yes, I am working Full-Time
Yes, I am working Part-Time
I am Not currently working
I am retired
I receive Disability
Other, please explain below
Please explain work situation here.
Are you receiving Unemployment?
Yes
No
Are you receiving SSD?
Yes
No
Are you receiving Food Stamps?
Yes
No
Do you receive State Health Insurance? (NJ FamilyCare)
Yes
No
Do you have any questions for us? Do you have any information you would like to share with us? Example: Out of work, death in family, living in motel etc. Do you have other needs or concerns at this time? (Example: in need of diapers, formula, clothing needs, food needs, past due bills etc.?) Please share this information here.
Spouse/Partner Name
Spouse/Partner's last day of work?
Number of Adults in your household
Number of Chldren in your household (You will be asked to bring birth certificates for each child)
Please list FULL NAME, BIRTHDATE and AGE for EACH CHILD IN YOUR HOUSEHOLD.
Total monthly family income at this time:
Monthly Rent/Mortgage
Are you or anyone in your household a Veteran?
Yes
No
Do you have a referral letter for services?
Yes
No
If yes, from whom is the referral letter?
Do you have pets and need pet food for them at this time? Check below
Hard Cat Food
Soft Cat Food
Hard Dog Food
Soft Dog Food
If your application is approved, you will need to bring all documentation / paperwork requested above. Please call or txt us at 856-625-8652 if you have any questions.
Yes, I understand
After you have completed this application and click the submit button, please TXT 856-625-8652 for the next steps.
Yes, I understand I must txt 856-625-8652
Submit Form