EFAA Financial Help Request Form

EFAA Financial Help Request Form

Please submit only one form. Submitting multiple forms will not speed up the review process. Forms are reviewed each weekday morning (subject to change). Submitting this form does not guarantee assistance or an appointment.
Where do you live?*

Longmont, Lyons, Niwot, Allenspark, Frederick, Firestone, Mead (St Vrain School District)Lafayette, Louisville, Superior, ErieCity limits of Boulder (including Gunbarrel, and certain areas within unincorporated Boulder County)Mountain communities within the Boulder Valley School District (BVSD) in Boulder County.Experiencing homelessness in the (city limits of Boulder) or mountain communities (within BVSD in Boulder County).Other area

Full Name (as shown on your ID)*

First Name(s)Middle Name(s)Last Name(s)
Date of Birth *

MonthDayYear
What is your current address, or the address you have been approved to move into?*

Street Address

Unit Number (if applicable)

CityState

Zip Code
What was your prior address before experiencing housing instability?*

Street Address

Unit Number (if applicable)

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email ( If you do not have an email, leave this section empty)
example@example.com
NO EMAIL- MUST SEND A TEXT MESSAGE
example@example.com
What type of Financial Assistance are you looking for? EFAA prioritizes rental assistance over any other assistance.*

Housing security depositRent assistanceMortgage AssistanceMobile home property taxesUpcoming minor medical, dental or vision expensesUpcoming minor car repairUtility Assistance (gas, electricity, propane, firewood)
Do you have a demand for rent or mortgage?*

YesNo
Do you have a court date for eviction?

YesNoNot sure
Do you have a Housing Choice Voucher?*

YesNoNot sure
What month rent or mortgage are you requesting assistance for?*

Past due rent or mortgageCurrent month's rent or mortgageNext month's rent or mortgage
On your demand, how much do you currently owe?*
On your demand, when is payment due?*

MonthDayYear
Please take a photo of your demand. A copy of your demand will be required before you can schedule an appointment.
Which best describes your current situation?

Experiencing HomelessnessDoubled UpStaying temporarily with other households (Couch surfing)Currently being evictedBeing asked to leave your current homeLiving in your car
Are your children enrolled in school? If yes, please share which school district.
Do you have children under the age of 18 living in your home?*

YesNo
Do you identify as someone with a disability?*

YesNo
Are you 60 years of age or older?*

YesNo
What is the best time of day to contact you?

MorningAfternoonEvening (5-7pm Tuesday or Thursday)
Have a demand for rent & are a family or individual-Score
Have demand for rent & are an older adult-Score
Have a demand for rent & have a disability- Score
Financial Assistance Request & are a family or are an individual- Score
Financial Assistance Request & are an older adult-Score
Financial Assistance Request & have a disability-Score
Are a family or individual & Past/Current/Next Rent Due-Score
Are an older adult & Past/Current/Next Rent Due-Score
Have a disability & Past/Current/Next Rent Due-Score
Final Score
EFAA serves the Mountain Communities within the Boulder Valley School District (BVSD) in Boulder County.

Next steps:

Once you submit this form it will be sent directly over to our Mountain Liason Navigator.

You can also reach out directly by texting or calling 720-422-7813 with any additional questions.
We offer utility assistance (gas, electricity, propane, or firewood) on a walk-in basis on most Mondays, Tuesdays, Thursdays, and Fridays from 12:00–3:00 PM.

Please review the following eligibility requirements:
- You must live within EFAA’s service area.
- You must have received a past due bill, disconnection notice, or shut-off notice from your utility company. Please bring a physical or electronic copy, if possible.
- You must not have received Energy Outreach Colorado (EOC) assistance from any agency between October 1, 2024, and September 30, 2025.
- You must present a photo ID.
Shelter & Housing Resources to Explore:

Boulder County Housing Helpline
- Website: Housing Helpline
- Contact: housinghelpline@bouldercounty.gov
- Phone:303-441-1206
- Details: Visit the website first and select the tab that best matches your need.
Emergency Shelters:

Safe Shelter of St. Vrain Valley (Family Shelter & Individuals & Domestic Violence)
- Address: Located in Longmont, CO 80502
- Phone: 303-772-0432
- 24/7 Crisis Line: 303-772-4422
- Website: https://www.safeshelterofstvrain.org/
General Shelters:

All Roads Shelter (Individual Adults & in Boulder County)
- Address:4869 Broadway, Boulder, CO 80304.
- Phone: 303-442-4646
- Website: https://allroadsboco.org/
Hope (Emergency Shelter)
- Address:Messiah Lutheran Church 1335 Francis StLongmont, CO 80501 and 2000 Pike Rd Unit A Longmont, CO 80501
- Phone: 720-494-4673, after 5PM 720-453-6999
- Website:https://hopeforlongmont.org/programs/
Samaritan House Fort Collins (Family Shelter & Individuals)
- Address: 460 Linden Center Dr., Ft. Collins, CO 80524
- Phone: 970-484-5010
- Website: Samaritan House Fort Collins
Samaritan House Denver (Family Shelter & Adult Women)
- Address: 2301 Lawrence St., Denver, CO 80205
- Phone: 303-294-0241
- Website: https://ccdenver.org/denver-samaritan-house/
Catholic Charities Guadalupe Shelter (Family Shelter & Individuals)
- Address: 1442 N 11th Ave., Greeley, CO 80631
- Phone: 970-353-6433
- Website: https://ccdenver.org/greeley/
Family HomeStead (Family Shelter & Individuals)
- Address: 999 Decatur Street Denver, CO 80204
- Phone: 303-623-6514
- Website:https://familyhomestead.org/
The Delores Project (Serving women, transgender, & nonbinary individuals)
- Address: Located in Denver, CO 80201
- Phone: 303-534-5411
- Website: https://thedeloresproject.org/
Colorado Coalition for the Homeless (Families & Individuals)
- Address: 2111 Champa St, Denver, CO 80205
- Phone: 303-293-2217
- Website: https://www.coloradocoalition.org/
- Details: Make an appointment with CCH for case management here
Comitis Crisis Center / Aurora Day Resource Center (Families & Severe weather)
- Address: 2178 Victor St, Aurora, Colorado 80045
- Phone: 303-341-9160
- Website:https://comitiscrisiscenter.org/comitis-crisis-center/
Domestic Violence (DV) Shelters:

Safehouse Progressive Alliance for Nonviolence (SPAN) (DV)
- Address: Boulder, CO
- Phone: 303-449-8623 and Crisis Line: 303-444-2424
- Website:https://www.safehousealliance.org/
Safe Shelter of St. Vrain Valley (Domestic Violence & Family Shelter & Individuals)
- Address: Located in Longmont, CO 80502
- Phone: 303-772-0432 and 24/7 Crisis Line: 303-772-4422
- Website: https://www.safeshelterofstvrain.org/
Maternity Homes:

The Little Flower Maternity Home
- Address:Louisville, CO 80027
- Phone:720-609-2934
- Website:https://littleflowermaternity.org/
Mother House at Haven Ridge Boulder (Pregnant people)
- Address: Boulder, CO 80308
- Website:https://havenridgeboulder.org/mother-house
You do not live in EFAA's Service Area

Please contact your local Family Resource Center:
- Sister Carmen: Lafayette, Louisville, Superior, Erie - Call 303-665-4342
- OUR Center: Longmont, Lyons, Niwot, Allenspark, Frederick, Firestone, Mead (St Vrain School District) - Call 303-772-5529
- Broomfield FISH: Broomfield - Call 303-465-1600
The following resources may be able to help. This is not a complete list:

State-wide Resources:
- Findhelp.org – Enter your zip code to locate services near you.
- Call 211, or chat 211 on their website
- PEAK – Apply for public benefits like health insurance, cash, and food assistance.
- The Emergency Mortgage Assistance Program (EMAP) If you are a homeowner (including lot rent for owner-occupied mobile homes) in need of mortgage assistance, and other homeowner related expenses.
- Colorado Emergency Rental Assistance (CERA)
Boulder County Related Resources:
- Housing Helpline for Boulder County- supports voucher holders with deposit assistance, and help with overdue rent.
- Eviction Prevention and Rental Assistance Services (EPRAS) - If you currently have a court date for an eviction, and live in the City of Boulder
- Immigrant Resources – Boulder County’s Immigration Resources page.
- Boulder County Connect – Access community support and manage food assistance online.
- Personal Finance Program at Boulder County. Free, personalized support.
You are not eligible for EFAA's services at this time.

Please explore the following resources
- If you currently have a court date for an eviction and live in the City of Boulder, please contact Eviction Prevention and Rental Assistance Services (EPRAS).
- If you owe over $5,000 in rent, Emergency Family Assistance Association (EFAA) is unable to assist at this time. Please contact Colorado Emergency Rental Assistance (CERA) to determine eligibility
- If you are a Housing Choice Voucher holder and have received a demand or eviction notice, please contact the Housing Helpline for Boulder County for assistance with deposit support and overdue rent.
- If you are a homeowner (including lot rent for owner-occupied mobile homes) in need of mortgage assistance and other homeowner related expenses. please contact the Emergency Mortgage Assistance Program (EMAP).
The following additional resources may be able to help. This is not a complete list:

State-wide Resources:

Findhelp.org – Enter your zip code to locate services near you.
Call 211, or chat 211 on their website
PEAK – Apply for public benefits like health insurance, cash, and food assistance.
The Emergency Mortgage Assistance Program (EMAP)
Colorado Emergency Rental Assistance (CERA)

Boulder Related Resources:

Housing Helpline for Boulder County - supports voucher holders with deposit assistance, and help with overdue rent.
Eviction Prevention and Rental Assistance Services (EPRAS) - If you currently have a court date for an eviction, and live in the City of Boulder
Immigrant Resources – Boulder County’s Immigration Resources page.
Boulder County Connect – Access community support and manage food assistance online.
Should be Empty: