Help For Home

For assistance with baby supplies, food or mental health services, please use the form below to request assistance.
We will contact you when your requested items are ready for pick-up. If you have any questions, please email:
info@shelterfromtherain.com

We will offer Mommy MeetUp Support Groups to help connect mothers and give assistance.
To rsvp for our next support group, click here

Request for help

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Status *

Single Legally Separated Divorced Married

Parent Driver's License or State ID *

Max file size: 20MB

What type of assistance do you need? *

Mental Health Services (Counseling Sessions) Baby Supplies (Diapers, Pull-Ups & Wipes) Household Items (Laundry Detergent, Paper Towels, Etc.) Support Group for Moms Virtual Tutoring for Students of Single Moms

Full Names and Ages of Children *

Child #1 Birth Certificate Upload (Required once per year - Photos Acceptable) *

Max file size: 20MB

Child #2 Birth Certificate Upload (Required once per year - Photos Acceptable) *

Max file size: 20MB

Child #3 Birth Certificate Upload (Required once per year - Photos Acceptable) *

Max file size: 20MB

Child #4 Birth Certificate Upload (Required once per year - Photos Acceptable) *

Max file size: 20MB

Child #5 Birth Certificate Upload (Required once per year - Photos Acceptable) *

Max file size: 20MB

Child #6 Birth Certificate Upload (Required once per year - Photos Acceptable) *

Max file size: 20MB

Child #7 Birth Certificate Upload (Required once per year - Photos Acceptable)Upload File *

Max file size: 20MB

Do you have transportation? *

Please include diaper sizes of the children under your care (verification will be required starting in 2023) and any additional comments here: *

Submit