General Request Form

Cobb Moms Helping Cobb -general request form 2026

Are you in need of help? Please complete this application if you live in Cobb County and have children age birth-18 years under your care living with you. There is a separate application on our website for assistance with food, toiletries and cleaning supplies.

We try to help the families of Cobb County with various needs whenever possible. Completion of this application does not guarantee assistance, but we will reach out to you as quickly as possible with more information and/or documentation that might be needed in order to process your request. Please fill out the information below to get started. After we receive your application, we will send an email to the email address used to complete this form, be sure to check your email over the next few days as we work through our applications.

Please confirm you meet our requirements by answering the following questions.

Privacy Policy

Eligibility

Unfortunately, we are unable to help you at this time. My suggestion is to visit our website, www.cobbmoms.org and look at the need assistance tab to find our resource list and also reach out to the school social worker (if you have school age children) and churches in your area.

General Information

The more information you give us here, the faster we can process the application.

Assistance

Finances

To help us understand your financial situation better, please answer the following questions. We need the cost of each expense that applies to your specific situation. The more information you provide to us in this form, the faster we can process your request! If not applicable, please list N/A. Don't skip anything that applies as we will need that information to process your request, and this will just delay your application.\n\nPlease be prepared to email info@cobbmomshelpingcobb.org with your ID, bills that you are requesting assistance for, last 4 weeks of paystubs and anything else relevant to your situation.