Download Applications Today!
Select the applications you need, and print and fill them out at home. Contact us with any questions, or just drop by the main office on Hawser and register in person. We have all the forms ready for you there, and would be happy to help you through the process.
Food Bank Application - Pima County
This Food Bank Application is for residents of Pima County as well as Cochise, Graham, Greeley, and Santa Cruz. If you have NOT received food from the Community Food Bank of Southern Arizona, or one of it's agencies in the past, you will need to fill this out to receive food service at IMPACT of Southern Arizona. (If you are, or ever have been, in the CFB system, you are already registered to come to Catalina for food assistance.) Once you have submitted your application to our office, and your information has been put into the database, you will be able to pick up your monthly distribution at any of the Community Food Bank locations around Southern Arizona.
Food Bank Application - Pinal County
This Food Bank Application is not yet in use for residents of Pinal County only. If you have NOT received food from the United Food Bank or one of it's agencies in the past, you will need to sign up with IMPACT using the IMPACT Application below to receive food service at IMPACT of Southern Arizona. If you are, or ever have been, in the United Food Bank system, you may already be registered to come to Catalina for food assistance. Once you have submitted your IMPACT application to our office, and your information has been put into the database, you will be able to pick up your monthly distribution at any of the United Food Bank locations in Pinal County. Within Pinal County, the DES form may be used to register for United Food Bank Assistance. Pinal Food Bank Applications may be out sometime in 2018.
IMPACT Program Application
You must live in our service area to qualify for all our other programs (other than the food programs described above). Please fill out all sections carefully and with clear printing to ensure the information is easy to enter correctly into our private database. This application will enroll you in our Clothing Bank program and all others that are open to any aged individual.
Seniors, this application will also be used to enroll you for transportation services to doctor appointments, if you should ever require a ride. If you are interested in one of our senior meals programs, please note this on the application. A Staff member will call you to make an appointment for an interview in order that you may learn more about those services, and together will be able to determine if you qualify.
Respite Day Care Application
Our Respite Day Care service is available to seniors dealing with cognitive and physical challenges who would like an opportunity to gather with others in similar circumstances, in a social setting once in a while. Experienced, certified caregivers will provide fun social, cognitive and physical activities, to make the day enjoyable. This application will be shared with our caregiver partners who will manage the assessment and class assignment processes. Please feel free to call our office if you have any questions when filling out this form. We look forward to having your loved one join us!
These classes are offered during the school year, and follow the local school district holiday breaks. This application is part of the Homeland Security questionnaire that you will need later. We use it only a a guide to be sure you are on the correct track to citizenship, before investing many months learning all the US History and Civics information required for the final Naturalization test and interview. Those are generally administered in English, so please consider an ESL class as well, if you need to either learn English, or just brush up.
ESL Registration Form
These classes are offered during the school year, and follow the local school district holiday breaks. ESL is available for residents within our service area, regardless of income. Residents outside our service area may submit an ESL Registration Form, but entry to the class will depend upon space availability. Space will be provided to our program clients before the class is opened to other area residents.
Be Sure To Bring The Following With You When You First Come In To Enroll For Service
Proof of Residency (a formal letter that has been mailed to your house to prove your address. Examples would include a utility bill, Healthcare invoice, mortgage or rental contract, and DES communication. A Driver's License is not an acceptable document for address verification in AZ. Please feel free to call with questions.
Birthdates and IDs for members of your household.