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Community Care Collaborative funds are available only to residents of Pasquotank, Camden, Perquimans, or Gates Counties. Our program supports families experiencing a temporary crisis or hardship, and all assistance is paid directly to the vendor. To qualify, you must have a reliable source of income. Assistance is not guaranteed.

Please complete all sections of the application so we can best assist you and connect you with appropriate resources. Be sure to monitor your email, as we may follow up by phone or email regarding 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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