City of Nashua Welfare Department Forms

The following forms must be submitted along with a completed application for consideration for General Assistance. To obtain an application for assistance, call the City of Nashua Welfare Department at 603-589-4555. These forms can be filled out on a smart phone or computer and submitted electronically, scanned and e-mailed to Welfare2@NashuaNH.gov, or printed and delivered to the City of Nashua Welfare Department.

• Rental Information Form
• Employment Verification Form
• Medical Report Form
• Motel Guest Form
• Employment Search Log
• Authorized Representative Form

Guidelines & Standards

• Welfare Department General Assistance Guidelines (PDF)
• City of Nashua Approved Financial Standards Effective December 22, 2020 (PDF)

Additional Assistance Programs

Rent and Utility Assistance during COVID-19

The New Hampshire Emergency Rental Assistance Program (NHERAP) provides rent and utility assistance to eligible households who have been impacted by the COVID-19 pandemic. NHERAP will cover up to 15 months of: 

• Past-due and future rent payments, including late fees and legal fees (back to April 1, 2020) 
• Past-due and future utilities and home heating costs (back to March 13, 2020) 
• Other housing-related costs such as internet and relocation expenses including rental application fees, utility hook-up fees, and security deposits 

Apply online using this application. If you need assistance in completing the application or need a paper application, call Southern NH Services (SNHS) at 603-889-3440. When you apply, SNHS will assist you in identifying the information and documents you need. They will review applications, and once approved, will process payments for expenses to landlords and utilities.

Homelessness Assistance

If you are experiencing homelessness in Nashua, contact the Coordinated Entry Line at 1-844-800-9911. They will complete an assessment and refer you to the appropriate agency for assistance. You may also contact NH 2-1-1 (Dial 211 in NH) for homeless resources outside of Nashua.

Long Term Assistance

If you are seeking information on long term assistance programs such as Financial Assistance To Needy Families (FANF), foster care, disability grants, Medicaid, nursing home care, elderly care, or the food stamp program, contact the New Hampshire Department of Health and Human Services at 1-800-852-3345. If you live in Greater Nashua, contact the State branch at 603-883-7726.

Entitlement Programs

For entitlement programs such as disability, Medicare, retirement benefits, or widow benefits, contact the Social Security Administration at 800-772-1213 or visit their website at Social Security Online.

If you are looking for information on other non-profit human service organizations within the Greater Nashua Region, visit the Greater Nashua Continuum of Care toolkit. This toolkit includes information on area homeless shelters, food pantries, mental health services, and more.

If you are seeking information on obtaining unemployment compensation benefits, job re-training, current employment opportunities, or job search techniques you may contact the Department of Employment Security at 603-882-5177 or visit their website at New Hampshire Employment Security Home Page.