Benevolence Assistance Request

At The Table, we believe in caring for one another in times of financial hardship. This form helps us understand how we might be able to support you. All information shared will be kept confidential and reviewed by our benevolence team.

Please note:

Assistance is typically provided for basic needs like housing, utilities, transportation, or medical expenses
Payments are made directly to service providers (landlords, utility companies, etc.), not to individuals
Maximum assistance is $1,500 per person per calendar year
A member of our team will contact you to schedule an in-person or phone conversation to discuss your request

Your name *

Email address *

Phone number *

Best times to contact you: *

Amount Requested *

Purpose of Request *

When is payment needed by?

If applicable

Document Upload

Please upload any supporting documents for your request (bills, receipts, mailing address and account information).

No files currently selected

Add up to 5 files. Maximum file size 10 MB.

Is there anything else you'd like us to know about your situation?

Would you be interested in meeting with someone to discuss financial planning or other support resources?

By submitting this form, I affirm that:

By submitting this form, I affirm that:

The information provided is true and complete to the best of my knowledge
I understand that submission of this form does not guarantee assistance
I agree to meet with a benevolence team member to discuss my request
I understand that any assistance provided will be paid directly to service providers

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.