This pre-qualification form will be used to determine ELIGIBILITY for potential rental assistance for residents of Park and Jefferson County West of C-470. We are serving the following zip codes: 80127, 80421, 80425, 80433, 80437, 80439, 80448, 80453, 80454, 80457, 80465, 80470, 80475.

A Colorado ID is required in order to receive assistance. Please note: This is NOT an application, nor a guarantee of assistance. For additional resources in Jefferson County:

Please call 2-1-1
Visit https://dola-online.maps.arcgis.com/apps/ZoneLookup/index.html?appid=dadc979eb66f41fb96e9ac935292330c for information on the Emergency Housing Assistance Program
Visit https://www.jeffco.us/4021/Emergency-Assistance-COVID-19 for the Jefferson County Emergency Assistance Application.

Once this form is submitted and reviewed, you will be notified as soon as possible by someone from The Mountain Resource Center regarding your eligibility. Please only fill out ONE form. If you are unable to complete this form please call 303-838-7552 and leave a message.

Rental Assistance Program Requirements & Pre-Qualification Form