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Community Care Collaborative Funds are only available for residents of Pasquotank, Camden, Perquimans, or Gates Counties. This program works to help families experiencing a temporary crisis or hardship and are paid directly to a vendor.. 

Please complete all information in order to best assist you and connect you with resources. Please monitor your email as we may reach out via phone or email to follow up on your application. 
Phone Type
Gender
Race/Ethnicity
Family Status
Do you live alone?
Do you have any handicaps or special needs? Required
Have you worked with any of the following Social Services
Check all programs you receive assistance from Required
Are you a veteran?
Employment Status
Payment frequency
Is anyone else in the home employed?
Have you received assistance from other agencies in the last 6 months for the same request?
CCC is a One Time charitable crisis assistance program. Clients are eligible to re-apply after 12 full calender months have passed. CCC has a 3 time maximum for assistance over a lifetime. Do you agree with these terms?
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