Rent/Utility Request Form


Before Completing the below Rental and/or Utility Request Form, please make sure you meet the following requirements:

  • You MUST Live in Denton County to receive assistance.
  • You MUST be able to pay for the following 30 days of your rent/utilities (which ever assistance you are requesting for) and be able to prove so.
  • You MUST have at least one dependent.
GLR Rental & Utility Assistance Request Form

Head of Household Information

Address
City
State/Province
Zip/Postal
Country

Other Adults in Household

First Name, Last Name, Middle Initial, Date of Birth, Social Security Number, & Ethnicity

Children in the Household

First Name, Last Name, Middle Initial, Date of Birth, Social Security Number, & Ethnicity

Rental Assistance Needed

Utiliy Assistance Needed

Please note that if you do NOT have at least one dependent then you may apply for assistance through Giving Hope, our partner non-profit.