MAC over 30 logo    Need Help Request Food & MARTA

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PLEASE NOTE: 

This form is no longer for financial assistance and is primarily for Food, MARTA and work clothes/shoes.

Filling out this form does not guarantee services. If we are unable to assist you we will do our best to give you information on other assistance resources. 
MAC currently serves 10 zip codes in Atlanta for food and MARTA – 30303, 30308, 30309, 30310, 30312, 30313, 30314, 30315, 30318, and 30363.

There are 3 Steps to completing the form. 

Step 1 Fill out Page 1 of the form below and hit Submit.

Step 2 Review page, scroll down and E-sign, hit Submit again.

Step 3 Find the email Verify: Signed Response and click on the website link to finish your submission. 
This form requires JavaScript enabled to function correctly. Most browsers have it enabled by default. To check if you have JavaScript on your web browser you can use this link - https://www.whatismybrowser.com/detect/is-javascript-enabled It also has some useful information about JavaScript.

THE FORMATS OF FIELDS FOR YOUR ANSWERS MUST BE CORRECT (DASHES, SLASHES, ETC.) THE DATABASE WILL NOT ACCEPT ANSWERS OUT OF FORMAT OR OUT OF DATE.

Fields with a red asterisk * are required.

Personal Information









Address












Landlord and Rental information



TOTAL HOUSEHOLD INCOME PER MONTH                                                                                                                                            What was your total household income after taxes  BEFORE THE COVID-19 pandemic?                                                                ENTER NUMBERS ONLY - NO DECIMALS  - if none enter 0

$
per month

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per month

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per month

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per month

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per month
MAC Assistance Requests



Your Personal Story

Consent to Release of Information and Liability Release


AFTER YOU SUBMIT BELOW YOU MUST SIGN ON THE NEXT PAGE. Scroll all the way down to the bottom of the page. You will be asked for your E-Signature. You will have to sign and enter your name and email again. It will send 2 emails - a notification and a confirmation email to the email address you provide. You must verify (click) the link in your confirmation email with subject "Verify Signed Response" from no-reply@formassembly.com to complete the application for assistance. Please check to make sure your email address is correct. Sometimes these emails are going to Junk/Spam folders, so please look there as well.