Request aid on behalf of a family

NOTE: Aid requests may be submitted only by qualified Footbridge Referral Partners.

Please consult this checklist to check if a family meets our eligibility guidelines: Eligibility Guidelines (as of April 2022)

To submit a request for aid, please click on this link and complete as much information as you have available.
Note: As of May 30, 2022, this new form replaces our prior case submission form.
The same information is requested.

If you have any issues filling out the form or if case information must be revised, please contact us at