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Commonly Used Application Forms

Food & Nutrition Services

  • Program Description: provides monetary assistance to households with limited income for the purchase of food.
  • Application Form # DSS-8207 

Simplified Nutritional Assistance Program (SNAP)

  • Program Description: identifies and provides Food and Nutrition Services benefits to North Carolina residents who meet certain requirements such as to those age 65 or older who receive Supplemental Security Income.
  • Application Form # DSS-6240

Medicaid

Work First

  • Program Description: North Carolina's Temporary Assistance for Needy Families (TANF) program, called Work First, parents can get short-term training and other services to help them become employed and self-sufficient.  Most families have two years to move off Work First Family Assistance. All adults who are included in the assistance payment must have a Mutual Responsibility Plan of Action agreement that requires the individuals to work or participate in work-related activities.  These adults must complete all of the requirements on their agreement each month before receiving Work First cash assistance
  • Application: you must apply in person. Completing the work book before you come into apply might be helpful, but is not required.

General Notes About Applications:

  • If you are unable to print the application, fill out the online request form to request an application by mail.
  • Medicaid Applications cannot be accepted via fax or the internet (i.e. emailed) 
  • WorkFirst applications are only available in person
You may choose to fill out and bring the below forms with you when applying for public assistance.

ePASS - Online Pre-Assessment Screening

ePASS (Electronic Pre-Assessment Screening Service) is a quick and easy way for you to get information about benefits and services that may help you, such as:

  • Food and Nutrition Services (formerly Food Stamps)
  • Emergency Assistance
  • Medicaid & North Carolina Health Choice (NCHC)
  • Work First Cash Assistance
  • Crisis Intervention Program (CIP)
  • Simplified Nutritional Assistance Program (SNAP) 

Visit the secure ePASS site now to check your potential eligibility.




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