​AGENCY FORMS​

• AGENCY SURVEY
• AGENCY NEEDS SURVEY
• AGENCY REPORT CARD (2020)
• HEAP/PIPP APPLICATION 2021/2022 new form should be received soon!
• WIC INCOME GUIDELINES 2021/2022
• ​​HEAD START ENROLLMENT APPLICATION - Click Here

EMERGENCY PROGRAM FORMS

• REQUIRED DOCUMENTS FOR EMERGENCY PROGRAMS (SCP, WCP, PIPP, HEAP) *NEW
• CUSTOMER DISPUTE AND APPEALS PROCEDURE - Click Here
• DOCUMENT OF RESPONSIBILITY (If utility bill is not in your name but you are responsible to pay it)
• EMPLOYMENT VERIFICATION FORM - Click Here
• HEAP & PIPP INCOME GUIDELINES FOR 2021/2022 - Click Here
• LETTER OF SUPPORT (If someone helps support you) - Click Here
• SEASONAL EMPLOYMENT VERIFICATION - Click Here
• SELF-DECLARATION OF INCOME FORM - Click Here
• SELF-EMPLOYMENT FORM - Click Here 
• IRS Form 4506-T Request for Transcript of Tax Return - Click Here
• SUMMER CRISIS PROGRAM (SCP) MEDICAL ELIGIBILITY FORM (must have physician statement verifying CHRONIC illness) - Click Here