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Eviction Prevention Prescreening Application

Family Promise of Midland has been awarded a very limited amount of funds to assist with eviction prevention. Not all applicants will qualify. If you meet the qualifications of the program, an FP outreach case manager will be in touch.


The following prescreen application must be completed in full to be considered.


Any application that is not complete will be denied.

If you meet the above qualifications, you MUST also agree to the prevention guidelines:

Applications will be reviewed in the order they are received. If you meet the qualifications of the program, an FP outreach case manager will be in touch. A return phone call does not guarantee funding.

Today's Date
Month
Day
Year

First & Last Name of Primary Adult:

Birthday of Primary Adult:

Birthday of Primary Adult
Month
Day
Year

First & Last Name of Secondary Adult:

Birthday of Secondary Adult:

Birthday of Secondary Adult:
Month
Day
Year

Names, birthdays, and ages of Children under 18 living in the home:

Type of Verifiable Income
Do you have an Eviction Court Date:
Yes
No
When is your Eviction Court Date (if applicable):
Month
Day
Year
Have you previously received funds from any organization to prevent eviction?
Yes
No
If yes, when did you receive assistance?
Month
Day
Year

Applications will be reviewed in the order they are received. If you meet the qualifications of the program, an FP outreach case manager will be in touch. A return phone call does not guarantee funding.

Prescreening applications are ONLINE ONLY. Please do not call or email. You will be required to provide the below documentation within one business day when requested. If the information is not received upon request, your application will be denied.

A FP Case Manager will require the following documentation if your application is approved:

·       Photo ID and Social Security Card

·       Valid Lease in applicant’s (must include child(ren))

·       Eviction Notice with amount owed

·       A birth record or other form of ID of children on the lease

·       Proof of income (pay stubs)

·       Current Bank Statement

If we are able to assist you, we will reach out within 48 hours.

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