subject_line
Cy-Fair Helping Hands Emergency Shelter Application
Today's Date (Select date from the calendar)
*
+
Your First & Last Name:
*
Your Phone #;
*
Are you Homeless?
*
Yes
No
How many children
under 18 are with you?
*
0
1 or more
Check the zip code
where you last lived.
*
77040
77041
77064
77065
77069
77070
77084
77092
77095
77429
77433
77449
none of the above
Do you have any income?
(salary, disability, child support, etc.)
*
Yes
No
STOP!
Based on your answers to the questions above, you do not qualify for Emergency Shelter from Cy-Fair Helping Hands. C
all 211 to see if they can help you locate assistance.