A Helping Hand
Please fill out this form to let us know what services can benefit you and your family. 
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Your Name
Phone Number
I need assistance with: *
Student(s) Name
If you answered other, please share what service(s) you need:
Additional comments:
Thank you!
I appreciate you taking the time to fill out this form so I can better assist you and your family. If you have any questions or concerns, don't hesitate to email me at lacuesta_f@4j.lane.edu or call me (541)790-6129. 
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