Request Assistance From Seton Center Inc | Emmitsburg, MD

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Home
Seton Center Programs
Seton Center Thrift Store
Volunteer
Donate
Events
About

Home
Seton Center Programs
Seton Center Thrift Store
Volunteer
Donate
Events
About

Request Assistance

Request Assistance

Request Service

Free Text

Fill out this short form and a Seton Center representative will contact you to schedule an in-person interview to complete the application process. Please call (301) 358-3188 (Ext 11) if you do not hear from us in two business days. If you cannot make it to your scheduled appointment, please call to reschedule.

Name*

Other Names Used

Current Street Address*

City*

State*

Zip Code*

Phone*

Email*

Date of Birth*

Get Assistance With* (check all that apply):

Rent/Utilities/Mortgage

Medical (non-dental)

Dental

Food

Other

If you checked "Other", what assistance do you need?

Family Type

Single

Married, No Children

Single Parent

Married, With Children

Other

Have you ever been on Active Duty in the US Armed Forces?

Yes

No

I don't know

Do you have a disability or disabling condition?

Yes

No

I don't know

Highest Level of Education Completed

What is your HOUSEHOLD monthly income from all sources?

Free Text

This should be the amount of income of everyone living in your household combined.

From which of the following sources did you receive income in the last 30 days? Check all that apply.

Full- or Part-time Employment

Unemployment

SSI

SSDI

VA Disability

Private Disability Insurance

Workers Compensation

TCA, TANF, and/or TDAP

Social Security

Military Pension

Non-Military Pension

Child Support or Alimony

Other

Do you have Health Insurance? Check all that apply.

None

Medical Assistance/Healthchoice

Maryland Children's Health Program

Medicare

VA Medical Services

Employer-provided

COBRA

Private Pay Health Insurance

Emergency Contact

Please list all family members who CURRENTLY live with you:

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

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Please try again later.

The following is a list of documentation required to process your request for assistance:

Photo ID
Proof of income (if applicable)
Bill requesting assistance with
Proof of other expenses

VISIT US

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Seton Center is a 501(c)(3) sponsored work of the Daughters of Charity. EIN 52-1182284.

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OUTREACH OFFICE HOURS

Mon - Fri: 10:00 am - 4:00 pm
Sat - Sun: Closed

STORE HOURS

Monday: Closed
Tue - Sat: 10:00 am - 4:00 pm
Sunday: Closed

THRIFT STORE HOURS

Monday: Closed
Tue - Sat: 10:00 am - 4:00 pm
Sunday: Closed

Donations accepted Tue-Sat, 9:30am-1pm

CONTACT US

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Hi. Do you need any help?

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