Please Note

Applying for services is a 2-step process. Your case cannot be processed until you have completed both steps.

Step 1 – Complete and submit this form.

Step 2 – You will be instructed to complete additional forms and provide supporting documents for eligibility verification.

Please follow the instructions carefully on the page after you submit this online application.

You must submit all required documents within two weeks of submitting this application or your case may be denied.

CAC Universal Application For Services

These are all the members of your household that you have entered.

I certify that the information I have provided is true and correct. I understand that misinformation or refusal to disclose information, which is essential for a determination of eligibility is a basis for disapproval of my application. Also, I hereby authorize Community Action Council of Howard County to verify/obtain any information and documentation, which will assist in determining my eligibility for assistance.
Electronic Signatures. The parties acknowledge and agree that this Universal Application Form may be executed by electronic signature, which shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature. Without limitation, “electronic signature” shall include electronically scanned and transmitted versions (e.g., via pdf) of an original signature.
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