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Who We Are
Are You In Need
Get Involved
Donate
Are you or your family in need of shoes?
Fill out the application below, and one of team will get in touch with you.
Application
First name
*
Last name
*
Phone
Email
*
Who are you requesting shoes for?
*
Myself
My child/children
Multiple household members
How many people are you requesting help for?
*
List the people who need help (name + age)
*
What is preventing you from purchasing shoes on your own right now?
*
What would happen if you do NOT receive shoes soon?
*
How urgent is this need? (1–10) (1 = can wait / 10 = urgent)
*
Are the shoes needed for school, work, or safety? (check all that apply)
*
School
Work
Safety issue (wet feet, winter, exposed toes, injury risk)
Other
Is anyone in the household currently employed?
*
Yes full-time
Yes part-time
No
What best describes your current income situation?
*
Employed
Unemployed
Disability / SSI / SSDI
Retired
Temporary/seasonal work
Other
Do you currently receive public assistance? (check all that apply)
*
SNAP/EBT
OHP/Medicaid
TANF
SSI/SSDI
Housing assistance
None
Prefer not to answer
What is your current housing situation?
*
Stable housing
Staying with others temporarily
Transitional housing/recovery housing
Homeless
Prefer not to answer
Which of these apply to your household? (check all that apply)
*
Single parent household
Recent homelessness (past 12 months)
Disability in household
Recovery / treatment / reentry
Emergency hardship (recent move, job loss, etc.)
None of the above
Prefer not to answer
Have you received help from One Step At A Time DC before?
*
Yes
No
If yes: approximate date:
Is there anything else you want our team to understand about your situation?
Submit
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