Food Assistance Online Application

Catholic Social Service

Household Income ($) *

Do you receive SNAP (food stamps) or Welfare? *

Yes

Currently Applying

Emergency Food Assistance

Application

Please list yourself and household members, Ages, Dates of Birth, and Relationship below *

Upload Mayor's Verification *

By clicking Yes below, I certify that all the information I have given above is true and correct. I hereby authorize Catholic Social Service to obtain or confirm information about my residency with the Mayors Council of Guam and government assistance such as SNAP or cash aid from the Department of Public Health and Social Services, effective for one calendar year from today, unless terminated by myself in writing to CSS, my Mayor's office, and DPHSS. *

Yes, I agree

No, I do not agree

Please tell us why you are applying for food assistance today. *

Please enter the amount ($) you receive per month.

Email: *

Check here to receive email updates

Phone

If so, what day of the month do you receive your benefits?

How many people are in your household? *

Name: *

Rent/Lease/Mortgage *

Upload DPHSS Certification or Other Document *

Physical Address