Project Deserve Application – Fill Out and Use This PDF

You must meet one of the following: 65 Years or Older or receives permanent disability income from SSI or SSD, or Meets the income guidelines.

If approved, you will be assisted with the amount due on your bill at time of review, up to $200 (checked November 10, 2026).

Household Net Income (not including food stamps), by Size: 1 is $13,850 Annual and $1,154 Month; 2 is $15,800 and $1,317; 3 is $17,800 and $1,483; 4 is $19,750 and $1,646; 5 is $21,350 and $1,779; 6 is $22,950 and $1,913; 7 is $24,500 and $2,042; 8 is $26,100 and $2,175 (checked November 10, 2026).

For all in household, enter Name (Last, First, MI), Social Security # (Adults only), Sex M or F and Age.

Enter the Applicant's telephone, the Applicant's email and the Street address, City, State, Zip and County.

Indicate with a check why you need assistance with your bill: Not enough monthly income, Loss of income, Unusually high utility bill, Unusually high medical bill, or Other (please explain).

Enter from your utility bill the Name of utility, Account number and Total bill amount.

Under Income Information, enter the Name of person, Source and Amount, and include ALL household income for all household members regardless of age or relationship.

Source examples include: employment, SSD, SSI, SS, TAF, food stamps, unemployment, worker compensation, child support, alimony, pension, VA benefits, etc. Each source requires official written verification.

Examples of verification include: paycheck stubs for most recent 30 days, letter from Social Security office (for current year), printout from DCF, printout from unemployment office, etc. Do not send original documents, only send copies.

Under Budget Information, list the Amount paid this month and the Regular monthly expenses for each of Rent, Electric, Gas, Water, Trash, Cable, Internet, Phone, Food stamps, Food (own $), Household, Clothes and Laundry. Do the same for Vehicle (payment), Vehicle insurance, Gas/transportation, Other insurance, Credit card payments, Pay day loan payments, Student loan payments, Other loan payments, Child care, Medical/hospital, Tithes/contributions, Cigarettes/alcohol, Recreation, Fines and Other.

Total cash received must agree with monthly expenditures paid this month.

Under Borrowed (check all that apply), check Friend, Family or Payday loan.

Mail: Center of Hope Inc. Project DESERVE P.O. Box 3237 Wichita, KS 67201 or Online: centerofhopeinc.org.

Signature of adult household member, Date and Daytime phone number.

You understand it is your responsibility to provide current proof of all household income, a current copy of your utility bill and another monthly bill in your name to determine your eligibility. You understand you need to continue making regular payments to your energy provider and that any Project DESERVE benefits which may be received do not take the place of your responsibility to pay the vendor. You understand your eligibility will be determined under the Project DESERVE guidelines. You understand this assistance is available only one time in a rolling 12-month period to those who demonstrate a financial need. You authorize your utility provider to release your payment history and other information to Center of Hope Inc. You also authorize Center of Hope Inc. to release application information to your energy vendor. You understand applications with incomplete information or verification will not be processed and will be destroyed. You certify that all information you have provided is complete and accurate.