Let's get started!

What town or municipality do you live in?

What town or municipality do you live in?

What pronouns do you use?

This allows TCI to effectively reach out to you. If you select "Text Message" as your Preferred Contact Method you agree to receive support messages from The Connection Initiative. Data/SMS rates may apply. To opt-out of messages, reply STOP at anytime.

What town or municipality does the person live in?

What town or municipality does the person live in?

What pronouns does the person use?

This allows us to reach you.

What is the age range of the person looking for a resource?

Please provide a brief description of your need.

In what timeframe do you need this connection?

How did you learn about The Connection Initiative?

What type of fuel do you use?

Please list the ages of the people in your household.

How much financial support do you need?

Please tell us about any relevant dietary requirements.

This will help us make a more efficient connection.

Your privacy is important to us. Please check this box if you consent to us sharing your information with our Resource Partners.

Please list any individual or organization with whom you would prefer we not share details of your request.

By making this request, you are agreeing to the terms of use and privacy policies of The Connection Initiative. Review these policies here: https://www.connectioninitiative.org/privacy

Add file or drop files here