Family Support Assistance | The Susan Ann Foundation

Important Information

This form is an initial inquiry. Submitting it does not guarantee eligibility, financial assistance, or approval. Requests are reviewed based on available program resources.

Return to Family Support

Ask About Assistance

Complete the form below to tell our Programs team what kind of support your household may need. A representative can follow up using your preferred contact method.

Applicant Information

Tell us how to contact you about your inquiry.

Full Name *

Email Address *

Phone Number *

City / Community *

Preferred Contact Method

Number of People in Household (optional)

Assistance Requested

Select all categories that apply to your family's situation.

Food and groceries Transportation and travel expenses Utility assistance Temporary housing or displacement after a fire Natural disaster recovery Emergency household essentials Other family support needs

When Is Assistance Needed? *

Estimated Assistance Amount (USD, optional)

Tell Us About Your Situation (optional)

Important: This form is an initial request for information and is not a guarantee of assistance. The Foundation will review inquiries based on program resources and eligibility. Please do not include confidential personal records.

I understand that submitting this inquiry does not guarantee assistance and that The Susan Ann Foundation may contact me about my request. *