Online Applications

How to sign up Online:

Five County Community Action uses an information Kiosk for the first part of its application. 

Please review these instructions prior to applying. You may also download instructions as a PDF file here: Kiosk – Client – Submitting Application online

Step 1: Create account by clicking New User button and proceeding to enter email and password.

CAP60 Kiosk 1

CAP60 Kiosk 2

Step 2: Enter Household Information
Progress can be monitored by referencing progress bar at the top of the page. All fields displaying red text are required to save the page.

CAP60 Kiosk 3

At the bottom of the page, click the applicable button to save and come back, save and continue the application process, or skip the current page (can be completed at a later time).

CAP60 Kiosk 4

Step 3: Enter Household Member
When prompted, select ‘Yes’ if household member being entered will be the person applying to the program and ‘No’ if not.

CAP60 Kiosk 5

Step 4: Proceed to edit or remove existing household member, add additional household members or proceed to enter income by clicking Next.

Complete household information and personal information for all members of the household.

CAP60 Kiosk 6

Step 5: Enter Income (additional sources can be added after saving initial income)

CAP60 Kiosk 7

Income should be provided for all household members 18 and older. For income such as child support, this must be listed because it is the parent or guardian receiving the income on behalf of the child.

Step 6: Apply for Programs by clicking the link to the right of the applicable household member.

IMPORTANT: Programs such as food pantry, housing, utility assistance, etc. cover the entire household. For these programs, please only have the primary applicant apply.

CAP60 Kiosk 8

CAP60 Kiosk 9

Step 7: Submit requested documents based on applied programs by clicking blue upload link/button.

Under Required Documents, click “Upload Required Documents.”

NOTE: The required documents needed will changes based on the programs that are selected.

Here are the required documents that must be uploaded:

    • Income verification for all members over 18

CAP60 Kiosk 10

Step 8: Complete survey if prompted, otherwise, proceed to Affirmation & Consent page.

 

Step 9: Save and complete at a later time or submit application.

CAP60 Kiosk 11

Your application will not be considered complete unless all information is completed and uploaded.

Please allow 3 business days for someone to follow-up with you as well. For any questions, please call Community Action at (435) 674-5757

Apply Now:

CAP60 Kiosk 11 - Five County Portal

Once you have read the above information, go to online application system to get started.