Bridge Beyond Benefits Application

Bridge Beyond Benefits is an 18-month pilot program that helps people become self-reliant and reduce the need for additional food resources like the Supplemental Nutrition Assistance Program (SNAP). Participants in Bridge Beyond Benefits will get help from a team of coaches. The program includes support with goal setting and financial education. Incentives are available to encourage life changes that lead to self-reliance. Participants will need to meet achievable program requirements to remain enrolled in Bridge Beyond Benefits.

Please answer all questions.

Program Information

View Program Details

 

 

Application Information

An email address must be entered to advance to the next screen.

Best way to reach you:
Do you need any of the following services?
I receive the following public assistance benefit(s)
Are you a U.S. citizen or non-citizen national or qualified alien?
Are you serving a sanction period for SNAP or OWF?
Are you paying back a fraud overpayment for OWF or PRC?
Are you serving an Intentional Program Violation ineligibility period?
Are you a parent of a minor child?
Are you part of a household with a minor child?
Are you pregnant with your first child?
Is anyone in your household eligible for child support?
If yes, does the child or children receive the child support?
Do you have a minor child or children who live outside of your home?
If yes, do you pay child support for your minor child or children who live outside of your home?

(Count all verified household members, including applicant)

(Employment, self-employment, disability payments, strike benefits, training allowances, Workers’ Comp, and unemployment)

Household Information

Complete the section below for all members of your household (other than applicant)

Additional Household Member #1

Add another household member?
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Additional Household Member #2

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Additional Household Member #3

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Additional Household Member #4

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Additional Household Member #5

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Additional Household Member #6

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Additional Household Member #7

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Additional Household Member #8

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Additional Household Member #9

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Benefit Assessment Questions

Education

Highest education level attained:

Employment

Are you working full-time (40 hours per week) at one employer?

Housing

Do you receive housing assistance?

Transportation

Check the one that best fits.

Debt

Debts. Check the one that best fits.

Savings

Family and Child Care

How do children or family needs affect be able to work or go to school? Check the one that best fits.

Physical and Mental Health

How do your physical and/or mental health needs affect being able to work or go to school? Check the one that best fits.

Social Networks

How reliable are your social networks and connections with people to provide advice, guidance, and support? Check the one that best fits.

Additional Questions

Are you willing to transition and remain off SNAP?
Are you willing to stay in the program for the entire 18 months?
Are you ready and willing to set goals for self-reliance and take steps to achieving them?
Are you willing to work with a Success Coach weekly on multiple goals?
Do you have a minimum of one to three hours per week to participate in this program?
Are you willing to change jobs to assist you in increasing your earning potential?
Do you want to find new employment?
Are you currently facing any repossession of property or in any eviction proceedings?
If yes, please complete the following 4 questions:
Are you willing to complete training or an educational program to assist you in increasing your earning potential?
Are you comfortable working with community partners to assist you in achieving your goals, such as non-profit and other organizations Cuyahoga County works with?

By signing this application, I promise that all my answers are true and complete as far as I know. I understand that the Benefit Bridge program is not a Federal or State Entitlement program and that this application does not guarantee that I will get into the program. It is the first step in being selected. Any false statements I make on the application may be grounds for disciplinary action up to and including dismissal from the program.

This institution is an equal opportunity provider. Visit https://www.fns.usda.gov/cr/fns-nondiscrimination-statement. Cuyahoga Job and Family Services provides access to an interpreter at no charge to customers who are limited-English proficient and individuals with impaired vision and/or hearing.

 


  
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