Hardin County Holiday Assistance 2020
Anyone in need of holiday assistance must complete this form. All school age children must reside at the Hardin County address listed on the application and be enrolled in Hardin County Schools to apply. All information will be verified. Applications will be open from October 5th through October 30th. NO LATE APPLICATIONS WILL BE ACCEPTED. If you need assistance or have questions, please contact the Family Resource or Youth Services Center at your child's school.
Email address *
Household Parent 1 Name (Last Name, First Name) Example: Smith, Charlie *
Household Parent 1 Title *
Household Parent 2 Name (First and Last Name or N/A if not applicable) *
Household Parent 2 Title *
Complete Household Address (No P.O. Boxes, include city and zip code) *
Phone Number (include area code- Example: 270-555-5555) **Must be working number so we can reach you with questions: *
Additional Phone Numbers (include to whom the number belongs): *
Best way to reach you? *
My family is interested in receiving a food box for the holidays: *
The following choice would best meet our holiday needs: *
Please mark which school your youngest SCHOOL-AGE child attends: *
My family is eligible for the following public assistance programs (check all that apply): *
Required
By checking the box below, I understand and agree that I am giving permission for the Hardin County School's FRYSC's to release information regarding me and my dependent children with any churches or community partners that help with holiday assistance. *
Required
By checking this box, I understand that the Hardin County School's FRYSC's will be using the information on this application to match my family with the person/agency that will best meet my family's needs. I also agree that I will not apply to any other holiday assistance program and that all information I provided on this application is accurate and true. *
Required
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