Skip to main navigation Skip to content

Fight hunger in Georgia with us. Join Team SVdP at the Hunger Walk/Run March 15! Register

Who We Are
What We Do
Get Involved
- Get Involved
- Events
- Volunteer
- Join
- Connect
Ways To Give
Members
Get Help

Donate

Who We Are
What We Do
Get Involved
- Events
- Volunteer
- Join
- Connect
Ways To Give
Members
Get Help

Holy Cross Intake Form

Request Financial Assistance

We are team of volunteers from Holy Cross Catholic Church in DeKalb County — offering help to nearby neighbors. Please complete the form below to request financial assistance, then a volunteer will contact you. You may be contacted initially via phone, email or text to discuss your needs. Thank you.

Holy Cross Intake Form

"*" indicates required fields

Client Type*

Is this your first time contacting us for assistance?

Yes, I am a New Client

No, I have been helped before.

Date and Location of Last Visit*

Head of Household Information

Name*

First Middle Last

Social Security Number

Last 5 digits only

Date of Birth*

mm/dd/yyyy

MM slash DD slash YYYY

Email Address*

Living Situation

Homeless

Hotel/Motel/Extended Stay

Room/Boarding House

Staying With Friend/Family/Other

Rent Apartment

Own Home

Address*

Street Address Address Line 2 City State ZIP Code

Hotel/Motel/Extended Stay Information

Hotel/Motel/Extended Stay Name Address City State ZIP Code

Apartment Complex Name

If applicable

Primary Phone Number*

Do you have a vehicle?*

Yes

No

No, but I have access to reliable transportation

How Many Adults In Household (18-59)

Please list ALL ADULTS in Household:

First Name

Last Name

Date Of Birth

Relationship

Last 5 of SSN

Click the + symbol to the far right to add additional names.

How Many Children In Household (0-17)

Please list ALL CHILDREN in Household:

First Name

Last Name

Date Of Birth

Relationship

Last 5 of SSN

Click the + symbol to the far right to add additional names.

How Many Seniors In Household (60+)

Please list ALL SENIORS in Household:

First Name

Last Name

Date Of Birth

Relationship

Last 5 of SSN

Click the + symbol to the far right to add additional names.

Assistance Requested (select all that apply):

Food

Utility

Rent/Housing

SNAP (Supplemental Nutrition Assistance Program)/Food Stamps

TANF (Temporary Assistance for Needy Families)

CAPS (Childcare and Parent Services)

Medicaid

WIC (Special Supplemental Nutrition Program for Women, Infants, and Children)

Clothing Voucher

Please tell us why you need assistance:

Please be as detailed and specific as possible.

Please note best day(s) and time(s) for a call back in the next three (3) days.

Newsletter

We'll keep you in the loop about all of our latest news, programs and ways to get involved.

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

First Name*

Last Name*

Email*

Zip Code*

Areas of Interest

Neighbor Resources

Volunteer Opportunities

Vincentian News & Updates

Donor and Impact News & Updates

Mission

To serve our neighbors with love and respect: delivering help, hope, and pathways to self-sufficiency.

Location & Hours

2050-C Chamblee Tucker Road
Atlanta, GA 30341

Monday - Friday:
8:30 AM – 4:00 PM

Contact

Main: (678) 892-6160

Assistance: (678) 892-6163

Pharmacy: (770) 687-2610

info@svdpgeorgia.org

Donations: gifts@svdpgeorgia.org

Facebook Twitter YouTube Instagram LinkedIn

Who We Are
What We Do
Get Involved
Ways To Give
Members
Get Help

Charity Navigator: 4 Stars

Gold Transparency

St. Vincent de Paul

Copyright © 2026. All Rights Reserved. St. Vincent de Paul Georgia.

Terms of Use
Privacy Policy