CINXE.COM

<!DOCTYPE html> <html lang="en" dir="ltr" > <head> <meta charset="UTF-8"/> <meta name="viewport" content="width=device-width, initial-scale=1.0"/> <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"/> <link rel="apple-touch-icon" sizes="57x57" href="/wp-content/themes/access/assets/img/apple-icon-57x57.png"> <link rel="apple-touch-icon" sizes="60x60" href="/wp-content/themes/access/assets/img/apple-icon-60x60.png"> <link rel="apple-touch-icon" sizes="72x72" href="/wp-content/themes/access/assets/img/apple-icon-72x72.png"> <link rel="apple-touch-icon" sizes="76x76" href="/wp-content/themes/access/assets/img/apple-icon-76x76.png"> <link rel="apple-touch-icon" sizes="114x114" href="/wp-content/themes/access/assets/img/apple-icon-114x114.png"> <link rel="apple-touch-icon" sizes="120x120" href="/wp-content/themes/access/assets/img/apple-icon-120x120.png"> <link rel="apple-touch-icon" sizes="144x144" href="/wp-content/themes/access/assets/img/apple-icon-144x144.png"> <link rel="apple-touch-icon" sizes="152x152" href="/wp-content/themes/access/assets/img/apple-icon-152x152.png"> <link rel="apple-touch-icon" sizes="180x180" href="/wp-content/themes/access/assets/img/apple-icon-180x180.png"> <link rel="icon" type="image/png" sizes="192x192" href="/wp-content/themes/access/assets/img/android-icon-192x192.png"> <link rel="icon" type="image/png" sizes="32x32" href="/wp-content/themes/access/assets/img/favicon-32x32.png"> <link rel="icon" type="image/png" sizes="96x96" href="/wp-content/themes/access/assets/img/favicon-96x96.png"> <link rel="icon" type="image/png" sizes="16x16" href="/wp-content/themes/access/assets/img/favicon-16x16.png"> <meta name="msapplication-TileColor" content="#112E51"> <meta name="msapplication-TileImage" content="/wp-content/themes/access/assets/img/ms-icon-144x144.png"> <link rel="icon" type="image/x-icon" href="/wp-content/themes/access/assets/img/favicon.ico"> <meta property="og:type" content="website" /><meta property="og:title" content="Applications & Forms – ACCESS NYC"/> <meta property="og:description" content="Translated, downloadable forms and links to applications"/> <meta name="twitter:card" content="summary"/> <meta name="twitter:site" content="@accssnyc" /> <meta name="description" content="Translated, downloadable forms and links to applications"/> <meta name="msvalidate.01" content="806B459DCA6D2A99414184CDCDBF9F3E"> <title>Applications & Forms – ACCESS NYC</title> <meta name='robots' content='max-image-preview:large' /> <link rel='dns-prefetch' href='//cdn.jsdelivr.net' /> <link rel='dns-prefetch' href='//www1.nyc.gov' /> <link rel='dns-prefetch' href='//www.googletagmanager.com' /> <link rel='dns-prefetch' href='//translate.google.com' /> <link rel='dns-prefetch' href='//access-nyc-s3-uploads.s3.amazonaws.com' /> <link rel='dns-prefetch' href='//s.webtrends.com' /> <link rel='dns-prefetch' href='//www.google-analytics.com' /> <link rel='dns-prefetch' href='//cdnjs.cloudflare.com' /> <link rel='preconnect' href='//access-nyc-s3-uploads.s3.amazonaws.com' /> <link rel="preload" href=/wp-content/themes/access/assets/fonts/noto-serif/NotoSerif.woff2 as="font" crossorigin> <link rel="preload" href=/wp-content/themes/access/assets/fonts/noto-sans/NotoSans-Italic.woff2 as="font" crossorigin> <link rel="preload" href=/wp-content/themes/access/assets/fonts/noto-sans/NotoSans-Bold.woff2 as="font" crossorigin> <link rel="preload" href=/wp-content/themes/access/assets/fonts/noto-sans/NotoSans-BoldItalic.woff2 as="font" crossorigin><link rel='stylesheet' id='style-default-css' href='https://access.nyc.gov/wp-content/themes/access/assets/styles/style-default.a7bd59bf.css' type='text/css' media='all' /> <style id='google-translate-element-inline-css' type='text/css'> font { pointer-events: none; } a { pointer-events: all; } /* .goog-te-banner-frame { display: none !important; } */ /* body { top: auto !important; min-height: auto !important; position: static !important; } */ </style> <style id='classic-theme-styles-inline-css' type='text/css'> /*! This file is auto-generated */ .wp-block-button__link{color:#fff;background-color:#32373c;border-radius:9999px;box-shadow:none;text-decoration:none;padding:calc(.667em + 2px) calc(1.333em + 2px);font-size:1.125em}.wp-block-file__button{background:#32373c;color:#fff;text-decoration:none} </style> <style id='global-styles-inline-css' type='text/css'> body{--wp--preset--color--black: #000000;--wp--preset--color--cyan-bluish-gray: #abb8c3;--wp--preset--color--white: #ffffff;--wp--preset--color--pale-pink: #f78da7;--wp--preset--color--vivid-red: #cf2e2e;--wp--preset--color--luminous-vivid-orange: #ff6900;--wp--preset--color--luminous-vivid-amber: #fcb900;--wp--preset--color--light-green-cyan: #7bdcb5;--wp--preset--color--vivid-green-cyan: #00d084;--wp--preset--color--pale-cyan-blue: #8ed1fc;--wp--preset--color--vivid-cyan-blue: #0693e3;--wp--preset--color--vivid-purple: #9b51e0;--wp--preset--gradient--vivid-cyan-blue-to-vivid-purple: linear-gradient(135deg,rgba(6,147,227,1) 0%,rgb(155,81,224) 100%);--wp--preset--gradient--light-green-cyan-to-vivid-green-cyan: linear-gradient(135deg,rgb(122,220,180) 0%,rgb(0,208,130) 100%);--wp--preset--gradient--luminous-vivid-amber-to-luminous-vivid-orange: linear-gradient(135deg,rgba(252,185,0,1) 0%,rgba(255,105,0,1) 100%);--wp--preset--gradient--luminous-vivid-orange-to-vivid-red: linear-gradient(135deg,rgba(255,105,0,1) 0%,rgb(207,46,46) 100%);--wp--preset--gradient--very-light-gray-to-cyan-bluish-gray: linear-gradient(135deg,rgb(238,238,238) 0%,rgb(169,184,195) 100%);--wp--preset--gradient--cool-to-warm-spectrum: linear-gradient(135deg,rgb(74,234,220) 0%,rgb(151,120,209) 20%,rgb(207,42,186) 40%,rgb(238,44,130) 60%,rgb(251,105,98) 80%,rgb(254,248,76) 100%);--wp--preset--gradient--blush-light-purple: linear-gradient(135deg,rgb(255,206,236) 0%,rgb(152,150,240) 100%);--wp--preset--gradient--blush-bordeaux: linear-gradient(135deg,rgb(254,205,165) 0%,rgb(254,45,45) 50%,rgb(107,0,62) 100%);--wp--preset--gradient--luminous-dusk: linear-gradient(135deg,rgb(255,203,112) 0%,rgb(199,81,192) 50%,rgb(65,88,208) 100%);--wp--preset--gradient--pale-ocean: linear-gradient(135deg,rgb(255,245,203) 0%,rgb(182,227,212) 50%,rgb(51,167,181) 100%);--wp--preset--gradient--electric-grass: linear-gradient(135deg,rgb(202,248,128) 0%,rgb(113,206,126) 100%);--wp--preset--gradient--midnight: linear-gradient(135deg,rgb(2,3,129) 0%,rgb(40,116,252) 100%);--wp--preset--font-size--small: 13px;--wp--preset--font-size--medium: 20px;--wp--preset--font-size--large: 36px;--wp--preset--font-size--x-large: 42px;--wp--preset--spacing--20: 0.44rem;--wp--preset--spacing--30: 0.67rem;--wp--preset--spacing--40: 1rem;--wp--preset--spacing--50: 1.5rem;--wp--preset--spacing--60: 2.25rem;--wp--preset--spacing--70: 3.38rem;--wp--preset--spacing--80: 5.06rem;--wp--preset--shadow--natural: 6px 6px 9px rgba(0, 0, 0, 0.2);--wp--preset--shadow--deep: 12px 12px 50px rgba(0, 0, 0, 0.4);--wp--preset--shadow--sharp: 6px 6px 0px rgba(0, 0, 0, 0.2);--wp--preset--shadow--outlined: 6px 6px 0px -3px rgba(255, 255, 255, 1), 6px 6px rgba(0, 0, 0, 1);--wp--preset--shadow--crisp: 6px 6px 0px rgba(0, 0, 0, 1);}:where(.is-layout-flex){gap: 0.5em;}:where(.is-layout-grid){gap: 0.5em;}body .is-layout-flow > .alignleft{float: left;margin-inline-start: 0;margin-inline-end: 2em;}body .is-layout-flow > .alignright{float: right;margin-inline-start: 2em;margin-inline-end: 0;}body .is-layout-flow > .aligncenter{margin-left: auto !important;margin-right: auto !important;}body .is-layout-constrained > .alignleft{float: left;margin-inline-start: 0;margin-inline-end: 2em;}body .is-layout-constrained > .alignright{float: right;margin-inline-start: 2em;margin-inline-end: 0;}body .is-layout-constrained > .aligncenter{margin-left: auto !important;margin-right: auto !important;}body .is-layout-constrained > :where(:not(.alignleft):not(.alignright):not(.alignfull)){max-width: var(--wp--style--global--content-size);margin-left: auto !important;margin-right: auto !important;}body .is-layout-constrained > .alignwide{max-width: var(--wp--style--global--wide-size);}body .is-layout-flex{display: flex;}body .is-layout-flex{flex-wrap: wrap;align-items: center;}body .is-layout-flex > *{margin: 0;}body .is-layout-grid{display: grid;}body .is-layout-grid > *{margin: 0;}:where(.wp-block-columns.is-layout-flex){gap: 2em;}:where(.wp-block-columns.is-layout-grid){gap: 2em;}:where(.wp-block-post-template.is-layout-flex){gap: 1.25em;}:where(.wp-block-post-template.is-layout-grid){gap: 1.25em;}.has-black-color{color: var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-color{color: var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-color{color: var(--wp--preset--color--white) !important;}.has-pale-pink-color{color: var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-color{color: var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-color{color: var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-color{color: var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-color{color: var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-color{color: var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-color{color: var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-color{color: var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-color{color: var(--wp--preset--color--vivid-purple) !important;}.has-black-background-color{background-color: var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-background-color{background-color: var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-background-color{background-color: var(--wp--preset--color--white) !important;}.has-pale-pink-background-color{background-color: var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-background-color{background-color: var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-background-color{background-color: var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-background-color{background-color: var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-background-color{background-color: var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-background-color{background-color: var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-background-color{background-color: var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-background-color{background-color: var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-background-color{background-color: var(--wp--preset--color--vivid-purple) !important;}.has-black-border-color{border-color: var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-border-color{border-color: var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-border-color{border-color: var(--wp--preset--color--white) !important;}.has-pale-pink-border-color{border-color: var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-border-color{border-color: var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-border-color{border-color: var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-border-color{border-color: var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-border-color{border-color: var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-border-color{border-color: var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-border-color{border-color: var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-border-color{border-color: var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-border-color{border-color: var(--wp--preset--color--vivid-purple) !important;}.has-vivid-cyan-blue-to-vivid-purple-gradient-background{background: var(--wp--preset--gradient--vivid-cyan-blue-to-vivid-purple) !important;}.has-light-green-cyan-to-vivid-green-cyan-gradient-background{background: var(--wp--preset--gradient--light-green-cyan-to-vivid-green-cyan) !important;}.has-luminous-vivid-amber-to-luminous-vivid-orange-gradient-background{background: var(--wp--preset--gradient--luminous-vivid-amber-to-luminous-vivid-orange) !important;}.has-luminous-vivid-orange-to-vivid-red-gradient-background{background: var(--wp--preset--gradient--luminous-vivid-orange-to-vivid-red) !important;}.has-very-light-gray-to-cyan-bluish-gray-gradient-background{background: var(--wp--preset--gradient--very-light-gray-to-cyan-bluish-gray) !important;}.has-cool-to-warm-spectrum-gradient-background{background: var(--wp--preset--gradient--cool-to-warm-spectrum) !important;}.has-blush-light-purple-gradient-background{background: var(--wp--preset--gradient--blush-light-purple) !important;}.has-blush-bordeaux-gradient-background{background: var(--wp--preset--gradient--blush-bordeaux) !important;}.has-luminous-dusk-gradient-background{background: var(--wp--preset--gradient--luminous-dusk) !important;}.has-pale-ocean-gradient-background{background: var(--wp--preset--gradient--pale-ocean) !important;}.has-electric-grass-gradient-background{background: var(--wp--preset--gradient--electric-grass) !important;}.has-midnight-gradient-background{background: var(--wp--preset--gradient--midnight) !important;}.has-small-font-size{font-size: var(--wp--preset--font-size--small) !important;}.has-medium-font-size{font-size: var(--wp--preset--font-size--medium) !important;}.has-large-font-size{font-size: var(--wp--preset--font-size--large) !important;}.has-x-large-font-size{font-size: var(--wp--preset--font-size--x-large) !important;} .wp-block-navigation a:where(:not(.wp-element-button)){color: inherit;} :where(.wp-block-post-template.is-layout-flex){gap: 1.25em;}:where(.wp-block-post-template.is-layout-grid){gap: 1.25em;} :where(.wp-block-columns.is-layout-flex){gap: 2em;}:where(.wp-block-columns.is-layout-grid){gap: 2em;} .wp-block-pullquote{font-size: 1.5em;line-height: 1.6;} </style> <link rel='stylesheet' id='wpml-blocks-css' href='https://access.nyc.gov/wp-content/plugins/sitepress-multilingual-cms/dist/css/blocks/styles.css?ver=4.6.10' type='text/css' media='all' /> <script async type="text/javascript" id="rollbar-js-before"> /* <![CDATA[ */ var _rollbarConfig = { accessToken: '6af0890a6ae9438e8597cd58400792cf', captureUncaught: true, captureUnhandledRejections: true, payload: { environment: 'accessnyc' } }; /* ]]> */ </script> <script async type="text/javascript" src="https://cdn.jsdelivr.net/gh/rollbar/rollbar.js@2.13.0/dist/rollbar.snippet.js" id="rollbar-js"></script> <script type="text/javascript" id="data-layer-inline-js-before"> /* <![CDATA[ */ window.dataLayer = window.dataLayer || []; /* ]]> */ </script><script async type="text/javascript" src="https://www.googletagmanager.com/gtag/js?id=UA-113020437-3" id="google-analytics-js"></script> <script async type="text/javascript" id="google-analytics-js-after"> /* <![CDATA[ */ function gtag() { dataLayer.push(arguments); } gtag('js', new Date()); if (window.hasOwnProperty('GOOGLE_OPTIMIZE')) { gtag('config', 'UA-113020437-3', {'optimize_id': 'GTM-KRC5PCG', 'transport_type': 'beacon'}); } else { gtag('config', 'UA-113020437-3', {'transport_type': 'beacon'}); } /* ]]> */ </script> <script type="text/javascript" id="google-tag-manager-inline-js-before"> /* <![CDATA[ */ (function(w, d, s, l, i) { w[l] = w[l] || []; w[l].push({ 'gtm.start': new Date().getTime(), event: 'gtm.js' }); var f = d.getElementsByTagName(s)[0], j = d.createElement(s), dl = l !='dataLayer' ? '&l=' + l : ''; j.async = true; j.src = 'https://www.googletagmanager.com/gtm.js?id=' + i + dl + '&' + 'gtm_auth=OEhw74R2OQJG93jZv-24tQ&' + 'gtm_preview=env-2&' + 'gtm_cookies_win=x'; f.parentNode.insertBefore(j, f); })(window, document, 'script', 'dataLayer', 'GTM-KL3B7LK'); /* ]]> */ </script><script type="text/javascript" src="https://translate.google.com/translate_a/element.js?cb=window.googleTranslateInit" id="google-translate-element-js"></script> <link rel="https://api.w.org/" href="https://access.nyc.gov/wp-json/" /><link rel="alternate" type="application/json" href="https://access.nyc.gov/wp-json/wp/v2/pages/8824" /><link rel="canonical" href="https://access.nyc.gov/applications-forms/" /> <link rel='shortlink' href='https://access.nyc.gov/?p=8824' /> <link rel="alternate" type="application/json+oembed" href="https://access.nyc.gov/wp-json/oembed/1.0/embed?url=https%3A%2F%2Faccess.nyc.gov%2Fapplications-forms%2F" /> <link rel="alternate" type="text/xml+oembed" href="https://access.nyc.gov/wp-json/oembed/1.0/embed?url=https%3A%2F%2Faccess.nyc.gov%2Fapplications-forms%2F&format=xml" /> <meta name="generator" content="WPML ver:4.6.10 stt:5,65,62,1,4,64,29,41,46,2,56;" /> <link rel="alternate" hreflang="en" href="https://access.nyc.gov/applications-forms/" /> <link rel="alternate" hreflang="ru" href="https://access.nyc.gov/ru/applications-forms/" /> <link rel="alternate" hreflang="ko" href="https://access.nyc.gov/ko/applications-forms/" /> <link rel="alternate" hreflang="ar" href="https://access.nyc.gov/ar/applications-forms/" /> <link rel="alternate" hreflang="ht" href="https://access.nyc.gov/ht/applications-forms/" /> <link rel="alternate" hreflang="zh-hant" href="https://access.nyc.gov/zh-hant/applications-forms/" /> <link rel="alternate" hreflang="fr" href="https://access.nyc.gov/fr/applications-forms/" /> <link rel="alternate" hreflang="pl" href="https://access.nyc.gov/pl/applications-forms/" /> <link rel="alternate" hreflang="ur" href="https://access.nyc.gov/ur/applications-forms/" /> <link rel="alternate" hreflang="bn" href="https://access.nyc.gov/bn/applications-forms/" /> <link rel="alternate" hreflang="x-default" href="https://access.nyc.gov/applications-forms/" /> <meta name="theme-color" content="#FFFFFF"> <link rel="manifest" href="/wp-content/themes/access/manifest.960190a2.json"> <script type="application/ld+json"> [{"@context":"https:\/\/schema.org","@type":"Organization","@id":"https:\/\/access.nyc.gov\/#organization","name":"ACCESS NYC","url":"https:\/\/access.nyc.gov","logo":{"@type":"ImageObject","@id":"https:\/\/access.nyc.gov\/#logo","url":"https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/img\/apple-icon-precomposed.png","width":192,"height":192,"caption":"ACCESS NYC"}},{"@context":"https:\/\/schema.org","@type":"WebSite","@id":"https:\/\/access.nyc.gov\/#website","url":"https:\/\/access.nyc.gov","name":"ACCESS NYC","description":"ACCESS NYC is an online public screening tool that you can use to determine the City, State, and Federal health and human service benefit programs for which you are potentially eligible to enroll.","publisher":{"@id":"https:\/\/access.nyc.gov\/#organization"},"inLanguage":"en"},{"@context":"http:\/\/schema.org","@type":"WebPage","mainEntityOfPage":{"@type":"WebPage","name":"Applications & Forms","dateModified":"2022-08-05 16:22:33"},"spatialCoverage":{"type":"City","name":"New York"}}] </script> </head> <body> <noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-KL3B7LK&gtm_preview=env-2&gtm_auth=OEhw74R2OQJG93jZv-24tQ&gtm_cookies_win=x" height="0" width="0" style="display: none; visibility: hidden"></iframe></noscript> <div class="page-wrapper"> <a class="sr-only sr-only-focusable" href="#content">Skip to main content</a> <header class="overflow-hidden"> <div class="color-mid-background flex justify-between py-1 px-3 print:block"> <div class="flex-none"><svg class="icon icon-logo-nyc"><use xlink:href="#icon-logo-nyc"></use></svg><span class="text-xsmall px-1 text-grey-mid hidden screen-desktop:inline-block"> Official website of the City of New York </span></div> <div class="o-text-controller text-end print:hidden" data-js="text-controller"> <button type="button" class="o-text-controller__control btn-link" aria-controls="aria-c-text-controller__options" aria-expanded="false" data-js="text-controller__control track" data-track-key="Text Controls" data-track-data='[{"action": "text-controls"}]'><svg class="o-text-controller__icon o-text-controller__icon-full icon-ui icon-3 hidden screen-desktop:inline-block" aria-hidden="true"><use xlink:href="#icon-ui-settings"></use></svg><svg class="o-text-controller__icon o-text-controller__icon-short icon-ui icon-3 text-blue screen-desktop:hidden" aria-hidden="true"><use xlink:href="#icon-ui-translate"></use></svg><span class="o-text-controller__title-full">Translate Text</span><span class="o-text-controller__title-short">Translate Text</span></button> <div id="aria-c-text-controller__options" class="o-text-controller__options hidden" aria-hidden="true"> <div class="notranslate o-text-controller__languages screen-tablet:flex screen-tablet:justify-end"> <div class="wpml-ls-statics-shortcode_actions wpml-ls wpml-ls-legacy-list-horizontal"> <ul><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-en wpml-ls-current-language wpml-ls-first-item wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native">English</span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-ru wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/ru/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="ru">Русский</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Russian<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-ko wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/ko/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="ko">한국어</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Korean<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-ar wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/ar/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="ar">العربية</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Arabic<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-ht wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/ht/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="ht">Kreyol</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Haitian-Creole<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-zh-hant wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/zh-hant/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="zh-hant">繁體中文</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Chinese (Traditional)<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-fr wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/fr/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="fr">Français</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>French<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-pl wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/pl/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="pl">polski</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Polish<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-ur wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/ur/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="ur">اردو </span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Urdu<span class="wpml-ls-bracket">)</span></span></a> </li><li class="wpml-ls-slot-shortcode_actions wpml-ls-item wpml-ls-item-bn wpml-ls-last-item wpml-ls-item-legacy-list-horizontal"> <a href="https://access.nyc.gov/bn/applications-forms/" class="wpml-ls-link"> <span class="wpml-ls-native" lang="bn">বাংলা</span><span class="wpml-ls-display"><span class="wpml-ls-bracket"> (</span>Bengali<span class="wpml-ls-bracket">)</span></span></a> </li></ul> </div> <div id="js-google-translate" class="hidden" aria-hidden="true"></div> <label class="flex flex-col ms-2 screen-desktop:mb-2" for="js-google-translate-control"> <div class="flex items-center mb-1"> <svg class="icon-ui-translate icon-3 text-blue" aria-hidden="true"> <use xlink:href="#icon-ui-translate"></use> </svg> <select id="js-google-translate-control" name="js-google-translate-control" class="btn btn-link font-normal" style="line-height: initial; min-width: auto;"> <option value="restore" selected="true" disabled="true">Select a Language</option> <option value="es">Español</option> </select> </div> <svg class="text-grey-mid" width="175" height="16" role="img"> <title id="icon-logo-google-translate-title">Powered by Google Translate</title> <use xlink:href="#icon-logo-google-translate"></use> </svg> </label> </div> <script type="text/javascript" nonce=""> /** * Localize stylesheets to the window */ window.STYLESHEETS = ["https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-ar.177e5ee4.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-default.a7bd59bf.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-es.fa45e20b.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-ko.970c34cd.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-ur.d2e95c6b.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-zh-hant.b22c9ba9.css"] /** * Callback for the Google Translate Widget */ window.googleTranslateInit = function() { new google.translate.TranslateElement({ pageLanguage: 'en', includedLanguages: 'es', autoDisplay: false }, 'js-google-translate'); } </script> </div> </div> </div> <nav class="o-navigation color-dark-background"> <div class="logo-access"> <a href="/" data-js="track" data-track-key="Main Nav" data-track-data='[{"action": "home"}]'> <svg class="icon icon-logo-full" aria-hidden="true"> <use xlink:href="#icon-logo-full"></use> </svg><span class="sr-only">Access NYC</span> </a> </div> <nav class="o-navigation__nav nav-inline text-end print:hidden" data-js="site-desktop-nav"><a class="screen-desktop:hidden" href="#o-mobile-nav" data-js="o-mobile-nav track" aria-expanded="false" data-track-key="Main Nav" data-track-data='[{"action": "menu"}]'> Menu </a><a href="https://access.nyc.gov/eligibility" class="hidden screen-desktop:inline-block" title="Am I Eligible?" > Am I Eligible? </a><a href="https://access.nyc.gov/programs" class="hidden screen-desktop:inline-block" title="Programs" > Programs </a><a class="o-navigation__search no-underline" href="#search" data-js="o-search-box track" data-track-key="Main Nav" data-track-data='[{"action": "search"}]'><svg class="icon icon-ui icon-3 hidden screen-tablet:inline-block" aria-hidden="true"><use xlink:href="#icon-ui-search"></use></svg>Search </a></nav> </nav> </header> <div class="o-mobile-nav z-40 color-mid-background print:hidden" id="o-mobile-nav" aria-hidden="true"> <a class="o-mobile-nav__close" href="#o-mobile-nav" data-js="o-mobile-nav track" aria-expanded="false" data-track-key="Main Nav" data-track-data='[{"action": "menu/close"}]'> close & return to site<svg class="icon icon-ui icon-3"> <use xlink:href="#icon-ui-x"></use> </svg> </a> <div class="o-mobile-nav__inner"> <h4 class="o-mobile-nav__header"> Get help now </h4> <nav class="nav-block"> <a href="https://access.nyc.gov/eligibility" title="Am I Eligible?" > Am I Eligible? </a> <a href="https://access.nyc.gov/programs" title="Programs" > Programs </a> <a href="/?s=" data-js="track" data-track-key="Main Nav" data-track-data='[{"action": "search"}]'> <svg class="icon icon-ui icon-3"> <use xlink:href="#icon-ui-search"></use> </svg>Search </a> </nav> </div> </div> <div class='relative'> <div class="o-search-box z-30 color-mid-background print:hidden" id="search" aria-hidden="true"> <div class="o-search-box__inner"> <div class="wrap"> <div class="usa-width-one-whole"> <a class="o-search-box__close" href="#content" data-js="o-search-box track" data-track-key="Main Nav" data-track-data='[{"action": "search/close"}]'> <svg class="icon-ui icon-3"> <use xlink:href="#icon-ui-x"></use> </svg><span class="sr-only">Close search</span> </a> <form class="o-search-box__form" method="get" action="/"> <input type='hidden' name='lang' value='en' /> <label class="type-small" for="search-field">Search for programs or services</label> <div class="input-search"> <input name="s" type="text" value="" placeholder="Search" id="search-field"> <button class="btn-text input-search__submit" type="submit"> <svg class="icon icon-ui-search"> <use xlink:href="#icon-ui-search"></use> </svg><span class="sr-only">Submit</span> </button> </div> </form> <div class="o-search-box__suggestions"> <div class="o-search-box__suggestions-header"> <h3>Programs</h3> <a class="link-more hidden screen-tablet:inline-block" href="/programs">See all programs</a> </div> <div class="o-search-box__suggestions-body"> <div class="o-search-box__suggestions-item"> <a href="https://access.nyc.gov/programs/supplemental-nutrition-assistance-program-snap/">Money to buy food</a> </div> <div class="o-search-box__suggestions-item"> <a href="https://access.nyc.gov/programs/cash-assistance/">Monthly cash help when you are in need</a> </div> <div class="o-search-box__suggestions-item"> <a href="https://access.nyc.gov/programs/fair-fares/">Ride for half price</a> </div> </div> <a class="link-more screen-tablet:hidden" href="/programs" aria-hidden="true">see all programs</a> </div> </div> </div> </div> </div> </div> <main class="color-light-background" id="content"> <article> <header class="c-header mt-3 print:mt-0"> <div> <h1 class="c-header__descriptor">Applications & Forms</h1> <h2 class="c-header__information color__alt mb-4"> Last Updated August 5, 2022 </h2> <div class="font-serif screen-tablet:text-large"><p>Click on the links below to view and then print the forms.</p> <p>NOTE: Some of the application(s) require additional information. Please review and complete the application(s) before submitting to an Agency.</p> </div> </div> </header> <div class="wrap pt-2 screen-desktop:pt-3 screen-desktop:layout-sidebar-gutter"> <aside> <nav class="c-side-nav sticky top-0 pt-1 print:hidden border-none"> <ul> <li class="border-none pb-0"> <a href="#section-1">Cash & Expenses</a> </li> <li class="border-none pb-0"> <a href="#section-2">Family Services</a> </li> <li class="border-none pb-0"> <a href="#section-3">Food</a> </li> <li class="border-none pb-0"> <a href="#section-4">Health</a> </li> <li class="border-none pb-0"> <a href="#section-5">Work</a> </li> </ul> </nav> </aside> <div class="o-content pt-2 screen-desktop:pt-0"> <section id="section-1"> <h3 class="font-normal border-b pb-3 border-grey-light">Cash & Expenses</h3> <p><strong>Cash Assistance </strong><br /> Instructions (Form 1301)<br /> <a href="https://otda.ny.gov/programs/applications/1301.pdf" target="_blank" rel="noopener noreferrer">English</a> | <a href="https://otda.ny.gov/programs/applications/1301-SP.pdf" target="_blank" rel="noopener noreferrer">Spanish</a> | <a href="https://otda.ny.gov/programs/applications/1301-RU.pdf" target="_blank" rel="noopener noreferrer">Russian</a> | <a href="https://otda.ny.gov/programs/applications/1301-KO.pdf" target="_blank" rel="noopener noreferrer">Korean</a> | <a href="https://otda.ny.gov/programs/applications/1301-CH.pdf" target="_blank" rel="noopener noreferrer">Chinese</a> | <a href="https://otda.ny.gov/programs/applications/1301-HA.pdf" target="_blank" rel="noopener noreferrer">Haitian-Creole</a> | <a href="https://otda.ny.gov/programs/applications/1301-AR.pdf" target="_blank" rel="noopener noreferrer">Arabic</a> | <a href="https://otda.ny.gov/programs/applications/1301-BE.pdf" target="_blank" rel="noopener">Bengali</a></p> <p>Application Form (LDSS 2921)<br /> <a href="https://otda.ny.gov/programs/applications/2921.pdf" target="_blank" rel="noopener noreferrer">English</a><span class="Apple-converted-space"> </span>|<span class="Apple-converted-space"> </span><a href="https://otda.ny.gov/programs/applications/2921-SP.pdf" target="_blank" rel="noopener noreferrer">Spanish</a><span class="Apple-converted-space"> </span>|<span class="Apple-converted-space"> </span><a href="https://otda.ny.gov/programs/applications/2921-RU.pdf" target="_blank" rel="noopener noreferrer">Russian</a><span class="Apple-converted-space"> </span>| <a href="https://otda.ny.gov/programs/applications/2921-KO.pdf" target="_blank" rel="noopener noreferrer">Korean</a> |<span class="Apple-converted-space"> </span><a href="https://otda.ny.gov/programs/applications/2921-CH.pdf" target="_blank" rel="noopener noreferrer">Chinese</a><span class="Apple-converted-space"> </span>|<span class="Apple-converted-space"> </span><a href="https://otda.ny.gov/programs/applications/2921-HA.pdf" target="_blank" rel="noopener noreferrer">Haitian-Creole</a><span class="Apple-converted-space"> </span>|<span class="Apple-converted-space"> </span><a href="https://otda.ny.gov/programs/applications/2921-AR.pdf" target="_blank" rel="noopener noreferrer">Arabic</a> | <a href="https://otda.ny.gov/programs/applications/2921-BE.pdf" target="_blank" rel="noopener">Bengali</a></p> <p>Instructions for Recertification (Form 3113)<br /> <a href="https://otda.ny.gov/programs/applications/1313.pdf" target="_blank" rel="noopener noreferrer">English</a> | <a href="https://otda.ny.gov/programs/applications/1313-SP.pdf" target="_blank" rel="noopener noreferrer">Spanish</a> | <a href="https://otda.ny.gov/programs/applications/1313-RU.pdf" target="_blank" rel="noopener noreferrer">Russian</a> | <a href="https://otda.ny.gov/programs/applications/1313-KO.pdf" target="_blank" rel="noopener noreferrer">Korean</a> | <a href="https://otda.ny.gov/programs/applications/1313-CH.pdf" target="_blank" rel="noopener noreferrer">Chinese</a> | <a href="https://otda.ny.gov/programs/applications/1313-HA.pdf" target="_blank" rel="noopener noreferrer">Haitian-Creole</a> | <a href="https://otda.ny.gov/programs/applications/1313-AR.pdf" target="_blank" rel="noopener noreferrer">Arabic</a> | <a href="https://otda.ny.gov/programs/applications/1313-BE.pdf" target="_blank" rel="noopener">Bengali</a></p> <p>Recertification (Form 3174)<br /> <a href="https://otda.ny.gov/programs/applications/3174.pdf" target="_blank" rel="noopener">English</a> | <a href="https://otda.ny.gov/programs/applications/3174-SP.pdf" target="_blank" rel="noopener">Spanish</a> | <a href="https://otda.ny.gov/programs/applications/3174-RU.pdf" target="_blank" rel="noopener">Russian</a> | <a href="https://otda.ny.gov/programs/applications/3174-KO.pdf" target="_blank" rel="noopener">Korean</a> | <a href="https://otda.ny.gov/programs/applications/3174-CH.pdf" target="_blank" rel="noopener">Chinese</a> | <a href="https://otda.ny.gov/programs/applications/3174-HA.pdf" target="_blank" rel="noopener">Haitian-Creole</a> | <a href="https://otda.ny.gov/programs/applications/3174-AR.pdf" target="_blank" rel="noopener">Arabic</a> | <a href="https://otda.ny.gov/programs/applications/1313-BE.pdf" target="_blank" rel="noopener">Bengali</a></p> <p>Cash Assistance Mail-in Recertification / Eligibility Questionnaire (Form M-327H)<br /> <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-E-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf" target="_blank" rel="noopener">English</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Sp-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Spanish</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Ru-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Russian</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Ko-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Korean</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Ch-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Chinese</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Hc-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Haitian-Creole</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Fr-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">French</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Ar-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Arabic</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Bn-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Bengali</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Po-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Polish</a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2022/04/M-327h-Ur-CA-Mail-in-Recertification_Eligibility-Questionnaire.pdf.pdf" target="_blank" rel="noopener">Urdu</a></p> <p><strong>Child Tax Credit (CTC)<br /> </strong>Form 1040 <a href="https://www.irs.gov/pub/irs-pdf/f1040.pdf" target="_blank" rel="noopener noreferrer">English</a></p> <p>Form 1040NR<br /> <a href="https://www.irs.gov/forms-pubs/about-form-1040-nr" target="_blank" rel="noopener">English </a></p> <p><strong>Child and Dependent Care Tax Credit<br /> </strong></p> <p>Form 2441<br /> <a href="https://www.irs.gov/pub/irs-pdf/f2441.pdf" target="_blank" rel="noopener">English</a></p> <p>Form 1040<br /> <a href="https://www.irs.gov/pub/irs-pdf/f1040.pdf" target="_blank" rel="noopener noreferrer">English</a></p> <p>Form 1040NR<br /> <a href="https://www.irs.gov/forms-pubs/about-form-1040-nr" target="_blank" rel="noopener">English </a></p> <p><strong>Earned Income Tax Credit (EITC)<br /> </strong>Schedule EIC<br /> <a href="https://www.irs.gov/pub/irs-pdf/f1040sei.pdf" target="_blank" rel="noopener">English </a><strong><br /> </strong></p> <p>Form IT-215<br /> <a href="https://www.tax.ny.gov/pdf/current_forms/it/it215_fill_in.pdf" target="_blank" rel="noopener">English </a></p> <p>Worksheet C in the Instructions Form for IT-215<br /> <a href="https://www.tax.ny.gov/pdf/current_forms/it/it215i.pdf" target="_blank" rel="noopener">English </a></p> <div><strong>Home Energy Assistance Program (HEAP) </strong></div> <div><a href="https://otda.ny.gov/programs/applications/3421.pdf" target="_blank" rel="noopener noreferrer">English</a></div> </section> <section id="section-2"> <h3 class="font-normal border-b pb-3 border-grey-light">Family Services</h3> <p><strong>Child Support Services</strong><br /> Application form with instructions<br /> <a href="http://otda.ny.gov/programs/applications/5143.pdf" target="_blank" rel="noopener">English</a><br /> Other Child Support forms (for <a href="https://www1.nyc.gov/site/hra/help/child-support-services.page" target="_blank" rel="noopener">Custodial</a> and <a href="https://www1.nyc.gov/site/hra/help/noncustodial-parents.page" target="_blank" rel="noopener">Noncustodial Parents</a>)</p> <p><strong>Family Planning Benefit Program (FPBP)</strong><br /> Application form with instructions<br /> <a href="https://www.health.ny.gov/forms/doh-4282_acces.pdf" target="_blank" rel="noopener noreferrer">English</a> | <a href="https://access.nyc.gov/wp-content/uploads/2017/03/FPBP_applicationinstructions_SP.pdf" target="_blank" rel="noopener noreferrer">Spanish</a></p> </section> <section id="section-3"> <h3 class="font-normal border-b pb-3 border-grey-light">Food</h3> <p><strong>Supplemental Nutrition Assistance Program (SNAP) </strong><br /> Application and recertification forms with instructions<br /> <a href="https://otda.ny.gov/programs/applications/4826.pdf" target="_blank" rel="noopener noreferrer">English</a> | <a href="https://otda.ny.gov/programs/applications/4826-SP.pdf" target="_blank" rel="noopener noreferrer">Spanish</a> | <a href="https://otda.ny.gov/programs/applications/4826-RU.pdf" target="_blank" rel="noopener noreferrer">Russian</a> | <a href="https://otda.ny.gov/programs/applications/4826-KO.pdf" target="_blank" rel="noopener noreferrer">Korean</a> | <a href="https://otda.ny.gov/programs/applications/4826-CH.pdf" target="_blank" rel="noopener noreferrer">Chinese</a> | <a href="https://otda.ny.gov/programs/applications/4826-HA.pdf" target="_blank" rel="noopener noreferrer">Haitian-Creole</a> | <a href="https://otda.ny.gov/programs/applications/4826-AR.pdf" target="_blank" rel="noopener noreferrer">Arabic</a></p> <p><a href="https://a069-access.nyc.gov/ACCESSNYC/application.do">Online Application</a></p> <p><strong>SNAP Periodic Report</strong><br /> <a href="https://access.nyc.gov/wp-content/uploads/2019/01/Periodic-Report-LDSS-4310_EN.pdf" target="_blank" rel="noopener noreferrer">English</a> | <a href="https://access.nyc.gov/wp-content/uploads/2019/01/Periodic-Report-LDSS-4310_SP.pdf" target="_blank" rel="noopener noreferrer">Spanish</a> | <a href="https://access.nyc.gov/wp-content/uploads/2019/01/Periodic-Report-LDSS-4310_RU.pdf" target="_blank" rel="noopener noreferrer">Russian</a> | <a href="https://access.nyc.gov/wp-content/uploads/2019/01/Periodic-Report-LDSS-4310_KO.pdf" target="_blank" rel="noopener noreferrer">Korean</a> | <a href="https://access.nyc.gov/wp-content/uploads/2019/01/Periodic-Report-LDSS-4310_CH.pdf" target="_blank" rel="noopener noreferrer">Chinese</a> | <a href="https://access.nyc.gov/wp-content/uploads/2019/01/Periodic-Report-LDSS-4310_HC.pdf" target="_blank" rel="noopener noreferrer">Haitian-Creole</a> | <a href="https://access.nyc.gov/wp-content/uploads/2019/01/Periodic-Report-LDSS-4310_AR.pdf" target="_blank" rel="noopener noreferrer">Arabic </a> | <a href="https://access-nyc-s3-uploads.s3.amazonaws.com/uploads/2021/07/Periodic-Report-LDSS-4310_BN.pdf" target="_blank" rel="noopener noreferrer">Bangla</a><br /> The SNAP Periodic Report Form asks SNAP recipients to inform HRA of any changes to their case. The report is due every six months after you start receiving or renew your benefits. If you do not submit it within six months, HRA will close your case.</p> <p><strong>Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)</strong><br /> Medical Referral Form<br /> <a href="https://www.health.ny.gov/forms/doh-799.pdf" target="_blank" rel="noopener noreferrer">English</a></p> </section> <section id="section-4"> <h3 class="font-normal border-b pb-3 border-grey-light">Health</h3> <p><strong>NYC Nurse-Family Partnership<br /> </strong>If you’re a service provider, you can learn more on the NYC Health website, and you can refer eligible patients/clients by filling out the referral form and faxing it to 347-396-4360 or emailing it to <a href="/cdn-cgi/l/email-protection#d4baadb7bab2a494bcb1b5b8a0bcfabaadb7fab3bba2"><span class="__cf_email__" data-cfemail="7d13041e131b0d3d15181c1109155313041e531a120b">[email protected]</span></a> .</p> <p>Referral form with instructions<br /> <a href="https://www1.nyc.gov/assets/doh/downloads/pdf/ms/nfp-client-referral-form.pdf" target="_blank" rel="noopener noreferrer">English</a></p> <p><strong>Public Health Insurance</strong><br /> Application form with instructions<br /> NOTE: This application is not for those seeking long-term care coverage.<br /> <a href="https://www.health.ny.gov/forms/doh-4220.pdf" target="_blank" rel="noopener noreferrer">English</a> | <a href="https://www.health.ny.gov/forms/doh-4220_es.pdf" target="_blank" rel="noopener noreferrer">Spanish</a> | <a href="https://www.health.ny.gov/forms/doh-4220_ru.pdf" target="_blank" rel="noopener noreferrer">Russian</a> | <a href="https://www.health.ny.gov/forms/doh-4220_ko.pdf" target="_blank" rel="noopener noreferrer">Korean</a> | <a href="https://www.health.ny.gov/forms/doh-4220_zh.pdf" target="_blank" rel="noopener noreferrer">Chinese</a> | <a href="https://www.health.ny.gov/forms/doh-4220_ht.pdf" target="_blank" rel="noopener noreferrer">Haitian-Creole</a></p> <p><a href="https://nystateofhealth.ny.gov/" target="_blank" rel="noopener">Online Application</a></p> <p><strong>Supplement A</strong><br /> NOTE: This supplement is also required for anyone applying who is age 65 or older, blind or disabled, or seeking long-term care care<br /> <a href="https://www.health.ny.gov/forms/doh-5178a.pdf" target="_blank" rel="noopener noreferrer">English</a> | <a href="https://www.health.ny.gov/forms/doh-5178a_es.pdf" target="_blank" rel="noopener noreferrer">Spanish</a> | <a href="https://www.health.ny.gov/forms/doh-5178a_ru.pdf" target="_blank" rel="noopener noreferrer">Russian</a> | <a href="https://www.health.ny.gov/forms/doh-5178a_ko.pdf" target="_blank" rel="noopener noreferrer">Korean</a> | <a href="https://www.health.ny.gov/forms/doh-5178a_ht.pdf" target="_blank" rel="noopener noreferrer">Haitian-Creole</a></p> </section> <section id="section-5"> <h3 class="font-normal border-b pb-3 border-grey-light">Work</h3> <p><strong>Summer Youth Employment Program (SYEP)</strong><br /> <a href="https://application.nycsyep.com/" target="_blank" rel="noopener noreferrer">Online application</a></p> <p><strong>NYS Unemployment Insurance</strong><br /> <a href="https://applications.labor.ny.gov/IndividualReg/xhtml/individual/emailVerification.faces" target="_blank" rel="noopener noreferrer">Online application</a></p> <p><strong>Workforce1</strong><br /> Explore Job Openings<br /> <a href="https://www1.nyc.gov/site/sbs/careers/find-a-job.page" target="_blank" rel="noopener">Register to attend a recruitment event</a></p> </section> <footer class="pb-3"> <p class="text-grey-mid m-0"> Last Updated August 5, 2022 </p> </footer> </div> </div> <div class="sticky bottom-0 pointer-events-none z-10"> <div class="wrap pb-3 flex justify-end items-end flex-col screen-tablet:flex-row"> <nav class="c-web-share pointer-events-auto mb-1 screen-tablet:mb-0 screen-tablet:me-2"> <button aria-controls="web-share-fallback" aria-expanded="false" class="btn btn-small btn-primary" data-js="web-share track" data-web-share='{"title": "Applications & Forms", "text": "ACCESS NYC is an online public screening tool that you can use to determine the City, State, and Federal health and human service benefit programs for which you are potentially eligible to enroll.", "url": "https://access.nyc.gov/?p=8824"}' data-js="copy track" data-track-key="Web Share" data-track-data='[{"action": "web-share"}]'> <svg class="c-web-share__icon icon-ui"> <use xlink:href="#icon-ui-share-2"></use> </svg>Share </button> <div aria-hidden="true" class="c-web-share__fallback color-info-status hidden:fadeInUp animated hidden right-0 bottom-100" style="width: 458px; max-width: calc(100vw - 32px);" id="web-share-fallback" role="region"> <div class="c-web-share__fallback-body"> <label class="c-web-share__label" for="web-share-url" tabindex="-1"> Share this URL </label> <input class="c-web-share__url p-1 w-full mb-2" data-copy-target="web-share-url" id="web-share-url" name="web-share-url" type="text" value="https://access.nyc.gov/?p=8824" tabindex="-1" /> <button aria-pressed="false" class="c-web-share__item c-web-share__copy btn btn-small btn-primary" data-copy="web-share-url" data-js="copy track" data-track-key="Web Share" data-track-data='[{"action": "web-share/copied"}]' tabindex="-1"> <svg class="c-web-share__icon icon icon-ui" tabindex="-1"> <use xlink:href="#icon-ui-copy"></use> </svg> <svg class="c-web-share__icon icon-pressed icon-ui me-1" tabindex="-1"> <use xlink:href="#icon-ui-check"></use> </svg>Copy URL </button> <a class="c-web-share__item btn btn-small btn-primary" href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Faccess.nyc.gov%2F%3Fp%3D8824" target="_blank" data-js="track" data-track-key="Web Share" data-track-data='[{"action": "web-share/facebook"}]' tabindex="-1"> <svg class="c-web-share__icon icon-ui" tabindex="-1"> <use xlink:href="#icon-ui-facebook"></use> </svg>Facebook </a> <a class="c-web-share__item btn btn-small btn-primary me-0" href="https://twitter.com/intent/tweet?text=ACCESS%20NYC%20is%20an%20online%20public%20screening%20tool%20that%20you%20can%20use%20to%20determine%20the%20City%2C%20State%2C%20and%20Federal%20health%20and%20human%20service%20benefit%20programs%20for%20which%20you%20are%20potentially%20eligible%20to%20enroll.%20https%3A%2F%2Faccess.nyc.gov%2F%3Fp%3D8824" target="_blank" data-js="track" data-track-key="Web Share" data-track-data='[{"action": "web-share/twitter"}]' tabindex="-1"> <svg class="c-web-share__icon icon-ui" tabindex="-1"> <use xlink:href="#icon-ui-twitter"></use> </svg>Twitter </a> </div> </div> </nav> <a href="#content" class="btn btn-small text-blue pointer-events-auto">Back to top</a> </div> </div> </article> </main> <footer class="o-footer color-mid-background"> <nav class="o-footer__nav print:hidden"> <ul class="o-footer__nav-list px-3"> <li class="o-footer__column-first"> <div class="type-h3 text-blue-dark">Get Help Now</div> <ul> <li> <a href="https://access.nyc.gov/eligibility/" title="Am I Eligible?" > Am I Eligible? </a> </li> </ul> <div class="type-h3 text-blue-dark">For Caseworkers</div> <ul> <li> <a href="https://access.nyc.gov/applications-forms/" title="Applications & Forms" > Applications & Forms </a> </li> <li> <a href="https://access.nyc.gov/training-support/" title="Training Materials" > Training Materials </a> </li> </ul> </li> <li class="o-footer__column-middle"> <div class="type-h3 text-blue-dark">Programs</div> <ul class="screen-tablet:layout-columns-gutter screen-desktop:layout-rows"> <li> <a href="/programs/?program_cat=cash-expenses" title="Cash & Expenses" > Cash & Expenses </a> </li> <li> <a href="/programs/?program_cat=child-care" title="Child Care" > Child Care </a> </li> <li> <a href="/programs/?program_cat=city-id-card" title="City ID Card" > City ID Card </a> </li> <li> <a href="/programs/?program_cat=education" title="Education" > Education </a> </li> <li> <a href="/programs/?program_cat=family-services" title="Family Services" > Family Services </a> </li> <li> <a href="/programs/?program_cat=food" title="Food" > Food </a> </li> <li> <a href="/programs/?program_cat=health" title="Health" > Health </a> </li> <li> <a href="/programs/?program_cat=housing" title="Housing" > Housing </a> </li> <li> <a href="/programs/?program_cat=work" title="Work" > Work </a> </li> <li aria-hidden="true"></li> </ul> </li> <li class="o-footer__column-last"> <div class="type-h3 text-blue-dark"> <span class="sr-only">About ACCESS NYC</span> <svg class="icon icon-logo-full"> <use xlink:href="#icon-logo-full"></use> </svg> </div> <ul> <li> <a href="https://access.nyc.gov/about/" title="About" > About </a> </li> <li> <a href="https://www.nyc.gov/nyc-resources/website-accessibility-statement.page" title="Digital Accessibility Resources" > Digital Accessibility Resources </a> </li> </ul> </li> </ul> </nav> <div class="o-attribution px-3"> <div class="o-attribution__flex border-grey-light"> <div class="text-blue-dark"> <p class="o-attribution__byline"> ACCESS NYC is maintained by the <span class="sr-only">The Mayor's Office for Economic Opportunity</span> </p> <svg style="max-width: 100%" width="332" height="63" viewBox="0 0 332 63" fill="none" xmlns="http://www.w3.org/2000/svg" aria-hidden="true"> <path d="M169.529 25.9626L173.134 22.405V11.5821L162.311 0.759277H126.246L115.423 11.5821V4.37217L111.818 0.759277H97.39L93.785 4.37217V11.5821L86.5671 18.8L79.3572 11.5821V4.37217L75.7443 0.759277H61.3164L57.7114 4.37217L54.1064 0.759277H39.6786L36.0736 4.37217V18.8L18.0328 0.759277H3.60499L0 4.37217V54.8657L3.60499 58.4707H18.0328L21.6457 54.8657V40.4379L39.6786 58.4707H54.1064L57.7114 54.8657V26.01L75.7443 44.0428V54.8657L79.3572 58.4707H93.785L97.39 54.8657V44.0428L115.423 26.01V47.6557L126.246 58.4707H162.311L173.134 47.6557V36.8329L169.529 33.22H151.489V36.8329H137.069V22.405H151.489V25.9626H169.529Z" fill="currentColor"/> <path d="M170.565 3.19439C170.905 3.19439 171.197 3.16276 171.197 2.76748C171.197 2.43544 170.873 2.39591 170.604 2.39591H170.059V3.19439H170.565ZM170.067 4.7439H169.616V2.01644H170.652C171.308 2.01644 171.648 2.2457 171.648 2.7991C171.648 3.29716 171.348 3.4948 170.936 3.54224L171.703 4.7439H171.197L170.494 3.57386H170.075V4.7439H170.067ZM170.549 1.29702C169.482 1.29702 168.652 2.13503 168.652 3.33669C168.652 4.45929 169.379 5.37635 170.549 5.37635C171.608 5.37635 172.439 4.54626 172.439 3.33669C172.439 2.13503 171.608 1.29702 170.549 1.29702ZM170.549 5.80326C169.134 5.80326 168.122 4.7439 168.122 3.33669C168.122 1.85042 169.245 0.870117 170.549 0.870117C171.838 0.870117 172.96 1.85042 172.96 3.33669C172.968 4.81505 171.846 5.80326 170.549 5.80326Z" fill="currentColor"/> <path d="M187.731 15H191.252V4.0933H191.293L194.311 15H197.169L200.187 4.0933H200.227V15H203.749V0.632133H198.235L195.76 10.2107H195.72L193.245 0.632133H187.731V15ZM209.057 12.0017C209.057 11.1766 209.701 10.8546 210.466 10.6735C211.21 10.4723 212.095 10.4119 212.578 10.1101C212.659 12.2633 212.116 13.1889 210.486 13.1889C209.721 13.1889 209.057 12.8468 209.057 12.0017ZM209.258 7.77582C209.419 6.89041 210.023 6.46782 210.969 6.46782C211.673 6.46782 212.619 6.76967 212.619 7.55447C212.619 8.1984 212.297 8.39964 211.713 8.52037C209.339 9.00333 205.636 8.74173 205.636 12.1425C205.636 14.2957 207.206 15.3018 209.198 15.3018C210.445 15.3018 211.753 14.9396 212.639 14.014C212.679 14.3561 212.719 14.678 212.84 15H216.281C215.879 14.175 215.879 13.209 215.879 12.3236V7.7557C215.879 4.79761 213.484 4.25428 211.009 4.25428C209.822 4.25428 208.614 4.45551 207.689 4.97871C206.763 5.52204 206.119 6.40745 206.059 7.77582H209.258ZM228.552 4.55613H225.05L223.078 11.3577H223.038L221.066 4.55613H217.444L220.14 11.8206C220.341 12.384 221.005 13.9938 221.005 14.5573C221.005 15.2817 220.422 15.7244 219.637 15.7244H218.45V18.5014H220.06C222.374 18.5014 223.601 18.2197 224.426 15.9257L228.552 4.55613ZM232.458 9.78813C232.458 8.46 232.941 6.87028 234.53 6.87028C236.12 6.87028 236.623 8.46 236.623 9.78813C236.623 11.1162 236.12 12.6858 234.53 12.6858C232.941 12.6858 232.458 11.1162 232.458 9.78813ZM229.037 9.78813C229.037 12.9273 231.291 15.3018 234.53 15.3018C237.77 15.3018 240.044 12.9273 240.044 9.78813C240.044 6.64893 237.77 4.25428 234.53 4.25428C231.291 4.25428 229.037 6.64893 229.037 9.78813ZM241.962 15H245.383V9.82837C245.383 8.52037 246.269 7.35324 247.959 7.35324C248.422 7.35324 248.824 7.43373 249.267 7.55447V4.43539C249.005 4.37502 248.724 4.3549 248.462 4.3549C246.993 4.3549 245.826 5.05921 245.323 6.38733H245.283V4.55613H241.962V15ZM250.651 4.37502H252.1C252.16 5.30068 251.537 6.10561 250.651 6.26659V7.87644C252.845 7.51422 253.831 5.98487 253.851 3.97256V0.632133H250.651V4.37502ZM254.267 11.559C254.367 14.4768 256.903 15.3018 259.378 15.3018C261.732 15.3018 264.389 14.3762 264.389 11.5791C264.389 10.7138 263.845 9.18443 261.732 8.76185C260.163 8.41976 257.869 8.23865 257.869 7.25262C257.869 6.52819 258.774 6.46782 259.338 6.46782C259.76 6.46782 260.143 6.54831 260.424 6.72942C260.706 6.91053 260.867 7.19225 260.867 7.63496H264.026C263.906 4.91834 261.511 4.25428 259.217 4.25428C257.165 4.25428 254.448 4.93847 254.448 7.45385C254.448 10.2711 257.144 10.3314 259.298 10.8748C259.901 11.0156 260.968 11.1766 260.968 11.9815C260.968 12.8066 260.022 13.0883 259.358 13.0883C258.875 13.0883 258.412 12.9676 258.09 12.7261C257.748 12.4645 257.527 12.0822 257.527 11.559H254.267ZM271.997 7.81607C271.997 11.9815 274.553 15.3018 279.08 15.3018C283.608 15.3018 286.164 11.9815 286.164 7.81607C286.164 3.65059 283.608 0.330287 279.08 0.330287C274.553 0.330287 271.997 3.65059 271.997 7.81607ZM275.74 7.81607C275.74 5.68302 276.666 3.54998 279.08 3.54998C281.495 3.54998 282.421 5.68302 282.421 7.81607C282.421 9.94911 281.495 12.0822 279.08 12.0822C276.666 12.0822 275.74 9.94911 275.74 7.81607ZM288.806 15H292.227V6.76967H294.28V4.55613H292.227V4.0933C292.227 3.14752 292.71 3.0469 293.495 3.0469C293.797 3.0469 294.099 3.06702 294.421 3.10727V0.692502C293.877 0.67238 293.314 0.632133 292.771 0.632133C289.853 0.632133 288.806 1.55779 288.806 4.55613H287.156V6.76967H288.806V15ZM296.254 15H299.675V6.76967H301.728V4.55613H299.675V4.0933C299.675 3.14752 300.158 3.0469 300.943 3.0469C301.245 3.0469 301.547 3.06702 301.869 3.10727V0.692502C301.325 0.67238 300.762 0.632133 300.218 0.632133C297.301 0.632133 296.254 1.55779 296.254 4.55613H294.604V6.76967H296.254V15ZM303.28 15H306.7V4.55613H303.28V15ZM306.7 0.632133H303.28V3.24813H306.7V0.632133ZM319.034 8.37951C318.792 5.62265 316.478 4.25428 313.882 4.25428C310.522 4.25428 308.409 6.62881 308.409 9.94911C308.409 13.1487 310.743 15.3018 313.882 15.3018C316.659 15.3018 318.833 13.692 319.134 10.8949H315.814C315.653 12.0017 315.049 12.6858 313.862 12.6858C312.413 12.6858 311.83 11.2974 311.83 9.94911C311.83 8.50025 312.132 6.87028 314.043 6.87028C314.909 6.87028 315.693 7.4941 315.714 8.37951H319.034ZM323.356 8.70148C323.557 7.43373 324.362 6.56844 325.569 6.56844C326.716 6.56844 327.541 7.53434 327.602 8.70148H323.356ZM331.023 10.6132C331.184 7.07151 329.312 4.25428 325.569 4.25428C322.49 4.25428 319.935 6.54831 319.935 9.74788C319.935 13.2493 322.249 15.3018 325.65 15.3018C327.984 15.3018 330.218 14.2554 330.842 11.8407H327.642C327.32 12.6054 326.515 12.9877 325.69 12.9877C324.241 12.9877 323.416 12.0419 323.356 10.6132H331.023ZM188.314 37H191.735V28.7697H193.788V26.5561H191.735V26.0933C191.735 25.1475 192.218 25.0469 193.003 25.0469C193.305 25.0469 193.607 25.067 193.929 25.1073V22.6925C193.385 22.6724 192.822 22.6321 192.279 22.6321C189.361 22.6321 188.314 23.5578 188.314 26.5561H186.664V28.7697H188.314V37ZM197.936 31.7881C197.936 30.46 198.419 28.8703 200.008 28.8703C201.598 28.8703 202.101 30.46 202.101 31.7881C202.101 33.1162 201.598 34.6858 200.008 34.6858C198.419 34.6858 197.936 33.1162 197.936 31.7881ZM194.515 31.7881C194.515 34.9273 196.768 37.3018 200.008 37.3018C203.248 37.3018 205.522 34.9273 205.522 31.7881C205.522 28.6489 203.248 26.2543 200.008 26.2543C196.768 26.2543 194.515 28.6489 194.515 31.7881ZM207.44 37H210.861V31.8284C210.861 30.5204 211.747 29.3532 213.437 29.3532C213.9 29.3532 214.302 29.4337 214.745 29.5545V26.4354C214.483 26.375 214.202 26.3549 213.94 26.3549C212.471 26.3549 211.304 27.0592 210.801 28.3873H210.761V26.5561H207.44V37ZM222.376 37H234.027V33.7803H226.119V31.0436H233.162V28.1459H226.119V25.6305H233.826V22.6321H222.376V37ZM245.931 30.3795C245.69 27.6227 243.376 26.2543 240.78 26.2543C237.419 26.2543 235.306 28.6288 235.306 31.9491C235.306 35.1487 237.641 37.3018 240.78 37.3018C243.557 37.3018 245.73 35.692 246.032 32.8949H242.712C242.551 34.0017 241.947 34.6858 240.76 34.6858C239.311 34.6858 238.727 33.2974 238.727 31.9491C238.727 30.5003 239.029 28.8703 240.941 28.8703C241.806 28.8703 242.591 29.4941 242.611 30.3795H245.931ZM250.656 31.7881C250.656 30.46 251.139 28.8703 252.728 28.8703C254.318 28.8703 254.821 30.46 254.821 31.7881C254.821 33.1162 254.318 34.6858 252.728 34.6858C251.139 34.6858 250.656 33.1162 250.656 31.7881ZM247.235 31.7881C247.235 34.9273 249.489 37.3018 252.728 37.3018C255.968 37.3018 258.242 34.9273 258.242 31.7881C258.242 28.6489 255.968 26.2543 252.728 26.2543C249.489 26.2543 247.235 28.6489 247.235 31.7881ZM259.838 37H263.259V31.3052C263.259 30.1582 263.823 29.0715 265.111 29.0715C266.982 29.0715 266.821 30.5204 266.821 31.9491V37H270.242V30.299C270.242 28.7898 269.96 26.2543 266.479 26.2543C265.231 26.2543 263.823 26.9183 263.199 27.9849H263.159V26.5561H259.838V37ZM275.23 31.7881C275.23 30.46 275.713 28.8703 277.303 28.8703C278.893 28.8703 279.396 30.46 279.396 31.7881C279.396 33.1162 278.893 34.6858 277.303 34.6858C275.713 34.6858 275.23 33.1162 275.23 31.7881ZM271.809 31.7881C271.809 34.9273 274.063 37.3018 277.303 37.3018C280.543 37.3018 282.817 34.9273 282.817 31.7881C282.817 28.6489 280.543 26.2543 277.303 26.2543C274.063 26.2543 271.809 28.6489 271.809 31.7881ZM284.413 37H287.834V31.9089C287.834 29.7758 288.357 29.0715 289.585 29.0715C290.51 29.0715 290.872 29.8362 290.872 31.0637V37H294.293V31.8887C294.293 30.1984 294.434 29.0715 295.903 29.0715C296.789 29.0715 297.332 29.7356 297.332 30.8625V37H300.753V30.7619C300.753 28.7697 300.391 26.2543 297.07 26.2543C295.662 26.2543 294.635 26.8379 293.81 27.9446C293.247 26.6769 292.08 26.2543 290.772 26.2543C289.504 26.2543 288.397 26.9385 287.773 27.9849H287.733V26.5561H284.413V37ZM303.163 37H306.584V26.5561H303.163V37ZM306.584 22.6321H303.163V25.2481H306.584V22.6321ZM319.119 30.3795C318.877 27.6227 316.563 26.2543 313.967 26.2543C310.607 26.2543 308.494 28.6288 308.494 31.9491C308.494 35.1487 310.828 37.3018 313.967 37.3018C316.744 37.3018 318.917 35.692 319.219 32.8949H315.899C315.738 34.0017 315.134 34.6858 313.947 34.6858C312.498 34.6858 311.915 33.2974 311.915 31.9491C311.915 30.5003 312.217 28.8703 314.128 28.8703C314.993 28.8703 315.778 29.4941 315.798 30.3795H319.119ZM187.167 51.8161C187.167 55.9815 189.723 59.3018 194.251 59.3018C198.778 59.3018 201.334 55.9815 201.334 51.8161C201.334 47.6506 198.778 44.3303 194.251 44.3303C189.723 44.3303 187.167 47.6506 187.167 51.8161ZM190.91 51.8161C190.91 49.683 191.836 47.55 194.251 47.55C196.665 47.55 197.591 49.683 197.591 51.8161C197.591 53.9491 196.665 56.0822 194.251 56.0822C191.836 56.0822 190.91 53.9491 190.91 51.8161ZM208.424 50.8703C209.933 50.8703 210.456 52.3393 210.456 53.6674C210.456 55.0961 209.933 56.6858 208.404 56.6858C206.854 56.6858 206.331 55.4986 206.331 53.6674C206.331 51.5142 207.498 50.8703 208.424 50.8703ZM203.031 62.5014H206.452V57.8731H206.492C207.196 58.8189 208.182 59.3018 209.47 59.3018C212.428 59.3018 213.877 56.7261 213.877 54.0095C213.877 51.0715 212.489 48.2543 209.209 48.2543C208.001 48.2543 206.995 48.7775 206.331 49.7635H206.291V48.5561H203.031V62.5014ZM221.099 50.8703C222.608 50.8703 223.131 52.3393 223.131 53.6674C223.131 55.0961 222.608 56.6858 221.079 56.6858C219.529 56.6858 219.006 55.4986 219.006 53.6674C219.006 51.5142 220.173 50.8703 221.099 50.8703ZM215.706 62.5014H219.127V57.8731H219.167C219.871 58.8189 220.857 59.3018 222.145 59.3018C225.103 59.3018 226.552 56.7261 226.552 54.0095C226.552 51.0715 225.164 48.2543 221.884 48.2543C220.676 48.2543 219.67 48.7775 219.006 49.7635H218.966V48.5561H215.706V62.5014ZM231.299 53.7881C231.299 52.46 231.782 50.8703 233.372 50.8703C234.961 50.8703 235.464 52.46 235.464 53.7881C235.464 55.1162 234.961 56.6858 233.372 56.6858C231.782 56.6858 231.299 55.1162 231.299 53.7881ZM227.878 53.7881C227.878 56.9273 230.132 59.3018 233.372 59.3018C236.611 59.3018 238.885 56.9273 238.885 53.7881C238.885 50.6489 236.611 48.2543 233.372 48.2543C230.132 48.2543 227.878 50.6489 227.878 53.7881ZM240.401 59H243.822V53.8284C243.822 52.5204 244.708 51.3532 246.398 51.3532C246.861 51.3532 247.263 51.4337 247.706 51.5545V48.4354C247.444 48.375 247.163 48.3549 246.901 48.3549C245.432 48.3549 244.265 49.0592 243.762 50.3873H243.722V48.5561H240.401V59ZM255.751 48.5561H253.638V45.3968H250.217V48.5561H248.486V50.7697H250.217V55.4181C250.217 58.2554 250.961 59.1006 253.879 59.1006C254.503 59.1006 255.127 59.0201 255.751 59V56.4846C255.449 56.4846 255.147 56.5249 254.865 56.5249C254.121 56.5249 253.638 56.3438 253.638 55.5187V50.7697H255.751V48.5561ZM267.657 48.5561H264.236V54.1503C264.236 56.0017 263.109 56.4846 262.365 56.4846C261.278 56.4846 260.674 56.0017 260.674 54.6132V48.5561H257.253V54.8345C257.253 57.5713 258.119 59.3018 261.117 59.3018C262.324 59.3018 263.652 58.6378 264.296 57.5713H264.337V59H267.657V48.5561ZM269.949 59H273.37V53.3052C273.37 52.1582 273.933 51.0715 275.221 51.0715C277.092 51.0715 276.931 52.5204 276.931 53.9491V59H280.352V52.299C280.352 50.7898 280.071 48.2543 276.589 48.2543C275.342 48.2543 273.933 48.9183 273.309 49.9849H273.269V48.5561H269.949V59ZM282.745 59H286.165V48.5561H282.745V59ZM286.165 44.6321H282.745V47.2481H286.165V44.6321ZM294.877 48.5561H292.764V45.3968H289.343V48.5561H287.612V50.7697H289.343V55.4181C289.343 58.2554 290.087 59.1006 293.005 59.1006C293.629 59.1006 294.253 59.0201 294.877 59V56.4846C294.575 56.4846 294.273 56.5249 293.991 56.5249C293.247 56.5249 292.764 56.3438 292.764 55.5187V50.7697H294.877V48.5561ZM306.22 48.5561H302.718L300.746 55.3577H300.706L298.734 48.5561H295.112L297.808 55.8206C298.009 56.384 298.673 57.9938 298.673 58.5573C298.673 59.2817 298.09 59.7244 297.305 59.7244H296.118V62.5014H297.728C300.042 62.5014 301.269 62.2197 302.094 59.9257L306.22 48.5561Z" fill="currentColor"/> </svg> </div> <button class="o-attribution__toggle btn-toggle btn-link" data-js="toggle" aria-controls="aria-c-learn-more" aria-expanded="false">Learn more</button> </div> <div id="aria-c-learn-more" aria-hidden="true" class="o-attribution__learn-more border-grey-light hidden"> <p class="mb-0"><a href="http://nyc.gov/opportunity" target="_blank" rel="nofollow noopener" tabindex="-1">The Mayor’s Office for Economic Opportunity</a> uses evidence and innovation to reduce poverty and increase equity. It advances research, data and design in the City’s program and policy development, service delivery, and budget decisions. <a href="http://nyc.gov/opportunity" target="_blank" rel="nofollow noopener" tabindex="-1">Learn more at nyc.gov/opportunity</a>.</p> </div> <div class="o-attribution__copyright o-attribution__flex border-grey-light"> <div> <p><svg class="o-attribution__logo-nyc" width="45" height="21" viewBox="0 0 45 15" fill="none" xmlns="http://www.w3.org/2000/svg"> <path d="M44.063 6.55069L45 5.62603V2.81301L42.187 0H32.813L30 2.81301V0.939041L29.063 0H25.313L24.376 0.939041V2.81301L22.5 4.68904L20.626 2.81301V0.939041L19.687 0H15.937L15 0.939041L14.063 0H10.313L9.37603 0.939041V4.68904L4.68699 0H0.936986L0 0.939041V14.063L0.936986 15H4.68699L5.62603 14.063V10.313L10.313 15H14.063L15 14.063V6.56301L19.687 11.25V14.063L20.626 15H24.376L25.313 14.063V11.25L30 6.56301V12.189L32.813 15H42.187L45 12.189V9.37603L44.063 8.43699H39.374V9.37603H35.626V5.62603H39.374V6.55069H44.063Z" fill="currentColor"/> <path d="M44.3322 0.632918C44.4206 0.632918 44.4966 0.624699 44.4966 0.521959C44.4966 0.435658 44.4123 0.425384 44.3425 0.425384H44.2007V0.632918H44.3322ZM44.2027 1.03566H44.0856V0.326754H44.3548C44.5253 0.326754 44.6137 0.386343 44.6137 0.530178C44.6137 0.659631 44.5356 0.711 44.4288 0.723329L44.6281 1.03566H44.4966L44.3137 0.731548H44.2048V1.03566H44.2027ZM44.3281 0.139768C44.0507 0.139768 43.8349 0.357576 43.8349 0.669905C43.8349 0.961685 44.024 1.20004 44.3281 1.20004C44.6034 1.20004 44.8192 0.984288 44.8192 0.669905C44.8192 0.357576 44.6034 0.139768 44.3281 0.139768ZM44.3281 1.311C43.9603 1.311 43.6973 1.03566 43.6973 0.669905C43.6973 0.283603 43.989 0.0288086 44.3281 0.0288086C44.663 0.0288086 44.9548 0.283603 44.9548 0.669905C44.9569 1.05415 44.6651 1.311 44.3281 1.311Z" fill="currentColor"/> </svg>© City of New York, 2024 All Rights Reserved. <br> NYC is a trademark and service mark of the City of New York.</p> </div> <nav class="grid grid-cols-1 pt-3 ml-0 screen-tablet:pt-0 screen-tablet:ml-3"> <a href="https://www.nyc.gov/nyc-resources/website-accessibility-statement.page" target="_blank" rel="nofollow noopener">Digital Accessibility Resources</a> <a href="http://www1.nyc.gov/home/privacy-policy.page" target="_blank" rel="nofollow noopener">Privacy Policy</a> <a href="http://www1.nyc.gov/home/terms-of-use.page" target="_blank" rel="nofollow noopener">Terms of Use</a> </nav> </div> </div> </footer> </div> <script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script><script type="text/javascript" nonce=""> window.LOCALIZED_STRINGS = window.LOCALIZED_STRINGS || []; window.LOCALIZED_STRINGS = window.LOCALIZED_STRINGS.concat([ { "label": "This field is required.", "slug": "NEWSLETTER_VALID_REQUIRED" },{ "label": "Email is required.", "slug": "NEWSLETTER_VALID_EMAIL_REQUIRED" },{ "label": "Please enter a valid email.", "slug": "NEWSLETTER_VALID_EMAIL_INVALID" },{ "label": "Please select a borough.", "slug": "NEWSLETTER_VALID_CHECKBOX_BOROUGH" },{ "label": "Almost finished... We need to confirm your email address. To complete the subscription process, please click the link in the email we just sent you.", "slug": "NEWSLETTER_SUCCESS_CONFIRM_EMAIL" },{ "label": "Thank you for subscribing!", "slug": "NEWSLETTER_SUCCESS_SUBSCRIBED" },{ "label": "There was an error with your submission. Please try again later.", "slug": "NEWSLETTER_ERR_PLEASE_TRY_LATER" },{ "label": "Please enter a value", "slug": "NEWSLETTER_ERR_PLEASE_ENTER_VALUE" },{ "label": "Recipient \"{{ EMAIL }}\" has too many recent signup requests", "slug": "NEWSLETTER_ERR_TOO_MANY_RECENT" },{ "label": "{{ EMAIL }} is already subscribed to list {{ LIST_NAME }}.", "slug": "NEWSLETTER_ERR_ALREADY_SUBSCRIBED" },{ "label": "This email address looks fake or invalid. Please enter a real email address.", "slug": "NEWSLETTER_ERR_INVALID_EMAIL" } ]); </script> <script type="text/javascript" nonce=""> window.STYLESHEETS = ["https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-ar.177e5ee4.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-default.a7bd59bf.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-es.fa45e20b.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-ko.970c34cd.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-ur.d2e95c6b.css","https:\/\/access.nyc.gov\/wp-content\/themes\/access\/assets\/styles\/style-zh-hant.b22c9ba9.css"] </script> <script type="text/javascript"> var relevanssi_rt_regex = /(&|\?)_(rt|rt_nonce)=(\w+)/g var newUrl = window.location.search.replace(relevanssi_rt_regex, '') history.replaceState(null, null, window.location.pathname + newUrl + window.location.hash) </script> <script type="text/javascript" id="webtrends-js-before"> /* <![CDATA[ */ var prod_dcsId_val = 'dcs222viqww0txf1nujrjyybv_3i9q'; var prod_host = 'access.nyc.gov'; /* ]]> */ </script> <script type="text/javascript" src="https://www1.nyc.gov/assets/home/js/webtrends/webtrends_v10.js" id="webtrends-js"></script> <script type="text/javascript" src="https://access.nyc.gov/wp-content/themes/access/assets/js/polyfill.8fe8e060.js" id="polyfill-js"></script> <script type="text/javascript" src="https://access.nyc.gov/wp-content/themes/access/assets/js/main.95777b5b.js" id="main-js"></script> </body> </html>