Apply for Aid 

First Name

Last Name

Address

Apartment/Unit

City

State StateSouth CarolinaOther

ZIP Code

County CountyAbbevilleGreenwoodLaurens

Email Address

Phone

Please describe in detail your reason for requesting assistance.

We may ask you to provide documentation such as bills, statements, late notices, and statements. Are you willing to submit such information to us? We may ask you to provide documentation such as bills, statements, late notices, and statements. Are you willing to submit such information to us? Yes No

Are you presently employed? Are you presently employed? Yes No

Where are you employed?

How long have you been with your present employer?

Are you receiving any financial assistance such as from other charities or Section 8 housing assistance? Are you receiving any financial assistance such as from other charities or Section 8 housing assistance? Yes No

If yes, what other assistance?

Do you have dependents? Do you have dependents? Yes No

How many dependents?

How did you learn about MercyWorks?