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**Please read this information carefully, as eligibility guidelines have changed**

Based on your income levels and location, you may be eligible for rental assistance if you’ve experienced hardship due to COVID-19.

The first step is filling out an online rental assistance pre-screen form (below).

Filling out this form does not guarantee assistance and additional information will be required in subsequent steps. Staff members will be contacting you within three business days.

Please ensure your contact information is accurate and your voicemail box is set up to receive messages.

After completing the online pre-screen, please familiarize yourself with these documents, as they are part of our intake process: HMIS Release of Information and BoS Client Rights and Responsibilities.

If you have further questions, please contact Elizabeth Knapp-Spooner, Community Programs Director, at eknapp@community-action.org.

Rental Assistance Pre-Screen form

WI Balance of State CoC
  • Household members (list everyone living in your household, related & unrelated)

  • GenderDisabled?RaceEthnicityDate of birth 
  • GenderDisabled?RaceEthnicityDate of birth 
  • GenderDisabled?RaceEthnicityDate of birth 
  • GenderDisabled?RaceEthnicityDate of birth 
  • GenderDisabled?RaceEthnicityDate of birth 
  • GenderDisabled?RaceEthnicityDate of birth 
  • Housing

  • ____times
  • (not exceeding 36 months)
  • Source:Gross monthly amount: $ 
    Add a new row
    Click the + to add other sources of income.