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Client Registration 2025
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Name/Nombre:
*
Your answer
Email Address
*
Your answer
Zip code/Código postal
*
Your answer
Do you receive SNAP, WIC, or Medicaid or are you enlisted military?/¿Recibe usted SNAP, WIC, Medicaid o está alistado en el servicio militar?
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WIC
SNAP
Medicaid
Enlisted Military
Other-if other please email us with a description of your situation
thedignitycloset@gmail.com
How many adults in your household?/¿Cuántas adultas en tu hogar?
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Your answer
Ethnicity/Etnicidad
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White/Caucasion
African American
Asian
Pacific Islander/Hawaiian
Hispanic
Middle Eastern
Multi-racial
Other
Children's Birthdates/Fechas de nacimiento de los niños
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