Assistance Request We are here to help, however we can. Request Form Date of Birth What's your ethnicity? —Please choose an option—American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite Please upload of photo of your Driver's License (file format accepted: jpg or png) Please Indicate all that apply to your request PrayerSpiritual CounselingMedicineClothingUtility**Rent**FoodMentoringID InfoDrug RehabAbuseOther **Note any approval for assistance with utilities, and rent, will be handled directly with the vendors. Upon approval, SHOM will only assist with past due amounts. Recipients must be will to provide Proof that assistance is needed. No cash or loans are given as a means of assistance. Please describe how we can assist you. Please note: You will be contacted within 24 to 48 hours by someone from our ministry. If you receive approval for assistance, there is a 6 month wait time before you can apply again.