You must be a resident of the State of Hawai’i to be eligible for Financial Assistance (Money) and/or SNAP benefits.
What benefits are you applying for?
(Check all that apply)
Money (Financial)
SNAP (Food)
If you are applying for SNAP benefits for someone else and not for yourself, we do not need information about your citizenship, immigration status, or social security number. You may need to tell us about your income and answer other questions. People who are not U.S. citizens may still qualify for certain benefits. If you do not have an SSN yourself, other family members who do have SSNs may still qualify.
Do you need an interpreter?
No
Yes
If Yes, please select a language
If Other, please specify language
What is the primary language spoken in your home?
How well is English spoken in your home?
Speaks well, adequate reading and writing skills
Speaks well, limited reading and writing skills
Speaks well, does not read or write English
Limited understanding
Does not speak or understand English
Required fields marked with an asterisk (*)
This person will be the primary contact for this application, even if they may not be applying for assistance.
First Name
*
Middle Name
Last Name
*
Most people applying for benefits must be interviewed. We often interview people on the phone. If you have one, please input a phone number that you can be reached at during business hours.
Phone Number
Gender
Select Gender...
Social Security Number (SSN)
Date of Birth
Email
We may contact you by mail. If you do not have a home address, please enter a mailing address where you can receive mail.
Required fields marked with an asterisk (*)
Home Address (Number and street, Landmark, or Location)
*
Apt / Space No.
City
*
State
*
Zip Code
*
Military Base (if residing in base housing)
If different from home address
Mailing Address (Number and street)
Apt/Space No
City
State
Zip Code