LSN KIDS Covid19 Food Relief Program (Outreach)
After you fill out this confidential form, we may contact you if we are able to assist your student(s).  Please provide specific details to tell us how covid19 has indirectly or directly impacted your family or student(s). Space is limited in this program and selected families will receive 1-4 months of food relief aid delivered to the address you provide us.
LSN KIDS Community Outreach Covid Food Relief Program only services families with children newborn - 18 years of age, living in the home.
If you have questions about this form, please email for assistance.  LSN KIDS reserves the right to accept or deny assistance to any student family based on available resources, needs assessment, or inaccurate or fraudulent information provided by the family during the application process. If abuse is expected in the home of the student(s), please contact law enforcement for your county by dialing 911 for direction. All information provided in this form will remain confidential and your information will not be sold or shared to any third party affiliates without your express written consent. LSN KIDS can not guarantee the time in which potential assistance may be rendered. However, all applicants will be informed of our receipt of this form. PLEASE ALLOW 3-5 days for processing.
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Email *
How are you related to the student/students in need? *
Explain how covid19 has impacted the life of the student(s) or child. *
Please provide what the student(s) has had difficulty obtaining or maintaining, and the reason covid19 food relief is needed.
In what grade is the child or student(s)? Check all that apply. *
How did you hear about this program? *
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