Application Form 2021

SUBMIT YOUR FORMAL APPLICATION TODAY

Please remember each program EDL offers and choose the right one for you. 

Fee is due after application is submitted for formal consideration. You will be redirected to another page once the application is submitted.

*Possible financial help to help pay bills. *

*RESOURCES*

INTERNET

First Name*
Last Name*
Phone*
STATE
Email Address*
your fACEBOOK page URL
Are you behind on bills? if so by how much?
are you disabled? if so do you collect ssdi or ssi?
do you have a mental illness?

DO YOU HAVE CHILDREN?

Please Select One
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What other nonprofits have you reached out too?
do you need moving expenses?
Mailing address
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how much do money do you seek?
Additional Info
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HOW WERE YOU REFERRED TO US? 
Google
Email
Other
Submit Application
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James Pino

About

Our mission at Elderly or Disabled Living is to provide help to the ones who need it. EDL’s way of helping others is to assist financially or by providing  resources. Moreover, EDL was created with helping others in mind. Caring for others maybe a little harder to find nowadays, but it is still here and alive. It's just harder to find. We are here for you.

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